耐力运动员的睾酮缺乏症

大家好，欢迎收听耐力实验室播客。

Hello, and welcome to the Endurance Lab Podcast.

我是比尔·埃文斯博士，运动科学教授，这个播客会介绍地球上一些顶尖运动员的生理机制，也会和运动科学家、精英运动员教练进行对话。

My name is doctor Bill Evans, professor of exercise science, and this podcast covers the physiology of some of the best athletes on the planet as well as talking with sports scientists and elite athletes coaches.

今天的播客内容其实是关于睾酮的。

Today's podcast is actually gonna be on testosterone.

这个话题的起因是我在一次客座讲座中，很多运动员问起一些比较新的补剂，比如喜来芝、东革阿里、维生素D等等。

This topic kinda came up because I was giving a guest lecture, and I had a lot of the athletes asking about some of these more novel supplements like Shilajit, Tangat Ali, vitamin d, a few others.

我猜在TikTok或者其他社交媒体平台上，这些都是热门话题。

And I guess on TikTok or maybe some other social media platforms, these are hot topics.

所以我就研究了一下其中几种，看看它们是否有效、效果有多大、具体有什么作用。

And so I kind of looked into a few of them to see if they worked, how much they worked, what they did.

这让我开始深入思考睾酮本身，以及睾酮水平与运动表现之间的关系。

And this really got me thinking about testosterone in general and about performance as it relates to testosterone levels.

那么，先打个基础，睾酮是一种类固醇激素，这意味着它会存在于血液中，直接穿过细胞膜，与细胞核结合，具体来说是作用于激素反应元件上。

So testosterone, just so we kind of lay the groundwork, is a steroid hormone, which means that it is gonna exist in the blood, and it's going to go directly through the cell membrane and bind to the nucleus, specifically at hormone response elements.

然后它会通过激活基因来上调一系列蛋白质。

And then it's gonna upregulate a bunch of proteins via activating their genes.

所以当我们谈论类固醇激素时，我们说的是结构性的变化，因为你实际上是在构建更多的基础设施，而不仅仅是激活不同的蛋白质通路。

So when we think about steroid hormones, we're talking about a structural change because you're gonna actually build more infrastructure as opposed to just activating different protein pathways.

所以，你知道，当我们想到睾酮时，我们想到的是那些传统的东西。

So, you know, when we think about testosterone, we think about the traditional stuff.

比如增加肌肉量、减少脂肪，以及男性性特征这些。

So increases in muscle mass, decreases in adiposity, in this case, like male sex characteristics.

很多这些事情都与高睾酮水平有关。

A lot of these things are gonna be associated with high testosterone levels.

而且，在流行文化中，特别是关于老年男性，有很多关于低睾酮的讨论。

And, you know, kind of in pop culture, there's a lot of talk around, particularly in the aging man, low T.

对吧？

Right?

所以就有像睾酮霜之类的干预措施来提高你的睾酮水平。

So there's like testosterone creams or whatever intervention to increase your testosterone.

我觉得这就是很多补剂发挥作用的地方。

And I think that's where a lot of these supplements come in.

另外，在增肌领域，很多人想增加肌肉量，所以他们也希望提高自己的睾酮水平。

And then also, just in general, in the hypertrophy world with so many people interested in trying to get more muscle mass, and so they wanna increase their testosterone levels.

所以在这期播客里，我真正想聊的是睾酮的实际生理学，不是那些生物学机制，而是真实的数值范围，以及运动后睾酮的急性变化和长期训练带来的慢性变化。

So with this podcast, I really wanna talk about the actual physiology when comes to testosterone and not necessarily the biological mechanisms, but kind of the the real ranges and what are some of the actual changes in testosterone both acutely with exercise and then also chronically with exercise training.

这些研究很多都基于安东尼·哈克尼博士的工作。

And a lot of this work is gonna be rooted in research by doctor Anthony Hackney.

哈克尼博士曾是——或者说现在是——北卡罗来纳大学教堂山分校的教授。

Doctor Hackney was a professor or is a professor at the University of North Carolina in Chapel Hill.

我在那里的时候他也在，挺酷的。

He was actually there when I was there, which was pretty cool.

他专门研究——我猜他称之为雄激素失调或雄激素缺乏。

And he studied specifically, like I think he calls it androgen dysregulation or androgen deprivation.

比如，他写过一封致编辑的信，标题是《雄激素缺乏症的患病率上升》。

So for example, he has a letter to the editor called increased prevalence of androgen deficiency.

就是这个名字。

That's what it's called.

针对不同年龄段的耐力训练男性跑者。

Endurance trained male runners across the lifespan.

他还有另一篇，关于男性耐力训练长跑运动员的低睾酮水平，以及训练年限的影响。

He's got another one, low testosterone in male endurance trained distance runners, the impact of years in training.

他还发表了一系列论文。

He's got another series of papers.

这篇是比较早的，1997年发表的，研究的是静息睾酮水平低的耐力训练男性在最大强度运动后的生殖激素反应。

This one's one of the older ones published in 1997, reproductive hormonal responses to maximal exercise in endurance trained men with low resting testosterone levels.

所以哈克尼博士的很多研究其实都聚焦于男性——当然他也有一些女性研究——他们如何表现出这种所谓的“RED-S”表型。

And so a lot of doctor Hackney's work has actually been kind of focusing on how males specifically, he also has some research in females, can exhibit this more or less red s phenotype.

对吧？

Right?

RED-S在女性中更常见，指的是运动中的相对能量缺乏，也就是长期热量摄入不足，或者运动消耗过高，导致消耗大于摄入。

And red s is gonna be the more common commonly understood phenomenon in females relative energy deficiency in sport, which is when you have this chronic caloric deficiency or high caloric expenditure through exercise, and it's burning more than you eat.

所以这会损害身体的正常功能，降低你的精力、运动表现、骨骼健康、生殖健康，通常表现为月经不调或停经、性欲低下、频繁应力性骨折、耐力下降等等。

And so it's gonna harm the body's normal functions, lower your energy, performance, bone health, reproductive health, typically characterized by missed or irregular periods, low sex drive, frequent stress fractures, low stamina, all these things.

它还可能带来很多心理健康方面的问题。

It also can have a lot of mental health implications.

这就是相对能量缺乏症，这个话题大家讨论得还挺多的。

So that's red s, and that is, you know, talked about somewhat frequently.

但在男性身上，因为他们没有月经，所以没那么容易观察到。

But in men, because they don't have periods, it's not as easy to observe.

因此，其中一个最好的指标就是检测睾酮水平。

And so one of the best markers is to actually look at testosterone.

所以你可能也猜到了，耐力跑者的睾酮水平实际上比不训练的人要低得多。

And so as you might expect in endurance runners, they actually have much lower testosterone levels than their untrained counterparts.

那我接下来就一篇一篇地过这些论文。

So I'm gonna kinda just like work through each of these papers.

我们会看个三四篇，分别聊聊每篇的结果，然后尽量把发现综合起来总结一下。

We'll go through like three or four of them, kinda talk about each of the results, and then do our best, I guess, to to synthesize the findings.

那我就从哈克尼博士的那篇原始论文开始讲。

So I'll pick the original one by doctor Hackney.

这篇论文的标题是《耐力训练男性在低静息睾酮水平下对最大运动量的生殖激素反应》。

So this paper is entitled reproductive hormonal responses to maximal exercise in endurance trained men with low resting testosterone levels.

这项研究是横断面研究，也就是说，他们找了一组耐力训练的运动员和一组未经训练的男性，先测量了他们的静息激素水平，然后让他们在跑步机上跑到力竭，之后每隔四小时采一次血，我记得是持续了二十四小时。

And in this study, it was cross sectional, which means they took just endurance trained athletes and untrained men, and they they took a resting hormonal profile and then did a max treadmill exercise test to exhaustion and then measured blood samples every four hours, I think, for up to twenty four hours.

然后他们做了一个叫曲线下面积的分析。

And then they did something what's called an area under the curve.

你可以这么理解：把每次测得的血液浓度值都收集起来，然后把曲线下方的区域涂上颜色，那个数值就是他们报告的结果。

So you can think about it as getting all these these blood concentrations and then coloring in the area under that curve, and that's the value that they report.

那他们发现了什么呢？

So here's here's what they found.

耐力训练男性的静息睾酮水平是16.6纳摩尔。

Resting testosterone in the Endurance trained men was 16.6 nanomoles.

而未经训练的男性是23.9纳摩尔。

And then in the in the untrained men, it was 23.9.

所以16.6对23.9，这差了多少？

So 16.6 versus 23.9, which is what?

大概低了25%吧？

Like 25% lower?

而且他们的催乳素水平也更低。

And then their prolactin levels were also lower.

耐力训练组是3.3，未训练组是6。

So it was 3.3 in the Endurance trained men and six in the untrained men.

有意思的是，当研究人员观察耐力训练组对运动的反应时，发现与静息值相比，睾酮、促黄体生成素和催乳素的曲线下面积值都显著增加了。

What's interesting too is that when they looked at the exercise response in the Endurance trained men, it produced a significant increase in testosterone, luteinizing hormone, and prolactin for the area under the curve values when compared to the resting values.

在未训练组中，他们观察到的唯一显著变化是运动后促黄体生成素的曲线下面积值比静息值降低了。

In the untrained men, the only significant change that they observed was a reduction in the exercise luteinizing hormone area under the curve versus the resting area under the curve value.

曲线下面积的变化百分比显示，睾酮、促黄体生成素和催乳素在两组之间存在差异。

And the area under the curve percent change values showed between group differences for testosterone, luteinizing hormone, and prolactin.

变化幅度在20到75之间。

And the level of change was from 20 to 75.

所以如果我们把未受训练的人当作一种对照或参考反应来看，他们在摘要里是这么说的：在一个功能正常的下丘脑-垂体-睾丸调节轴内，结论是耐力训练的男性表现出一种非典型的反应。

So if we look at the untrained men as kind of a control or a reference response, this is what they say in the abstract, quote, within a functioning hypothalamic pituitary testicular regulatory axis, it's concluded that the Endurance trained men display an atypical response.

所以这算是早期的一篇论文，他们开始指出，嘿，

So this was kinda one of the first papers where they showed that, hey.

耐力训练的男性身上有些奇怪的现象，他们的反应有点不太正常。

Something weird is going on with Endurance trained men where they're having a somewhat atypical response.

当你去看那篇论文的原文时，你会发现他们引用了一些更早的数据，比如1990年关于下丘脑-垂体-睾丸轴的研究。

And when you look at the actual publication, you can see that they reference some older data from, like, nineteen ninety pituitary testicular axis.

基本上，这个轴被打乱了。

And, basically, it gets disrupted.

所以他们当时的意思就是，嘿，

And so they were kinda saying like, hey.

这些在男性身上的发现，似乎和女性的情况类似。

These these findings in men appear to to mimic women.

所以这算是早期的一篇论文，表明这种情况可能因为耐力训练而发生。

And so this was kinda one of the earlier papers that showed that in this could happen as a function of endurance training.

这之所以重要，是因为很多耐力跑者都对这些睾酮补充剂感兴趣，想用它来提高表现，因为在男性、特别是耐力训练的男性中，血液中的雄激素水平似乎有所下降。

And the reason this is important is because a lot of these endurance runners are interested in taking these testosterone supplements to improve performance because in in men, endurance trained men, there appears to be, like, this decrease in the level of androgens in the blood.

所以如果水平低了，理论就是，哦，那我们需要提高它们来改善肌肉恢复。

And so if they're low, then the theory is, oh, well, we need to increase these to improve muscle recovery.

我们会在播客后面讨论为什么我认为这不一定是真的。

We're gonna talk about later in the podcast why I don't think that's necessarily true.

我觉得这可能是一个潜在的错误结论。

Like, I think that might be a potentially false conclusion.

简单来说，这主要基于一个观察：训练越刻苦，睾酮水平就会下降。

And that's mainly based on, in short, the observation that the harder you train, the you're gonna see drops in testosterone.

而且训练越刻苦，表现就越好。

And that the harder you train, the better performance is.

所以在某些方面，我们看到那些睾酮水平较低的人，反而有更高的表现水平。

And so in some ways, we see that in people with lower testosterone, they have higher performance levels.

对吧？

Right?

但这并不是因果关系。

Now that's not causative.

你明白吗？

You know?

我们并不是在做干预实验，试图逆转这种情况，看看对表现有什么影响。

It's not like we're doing an intervention where we're trying to reverse it and see what happens to performance.

事实上，在一些更偏向东方草药的疗法中，他们对老年男性做过类似研究，结果显示这些草药能增强力量和心肺耐力。

In fact, they do that in older men with some of these more eastern medicinal herbs, and they show that it can increase strength and cardio respiratory endurance.

但话说回来，这些研究对象是老年男性，他们的睾酮水平本来就低得多。

But, again, these are in older men with much lower testosterone levels.

这个我们后面再谈。

So we'll come back to that.

好的。

Alright.

接下来我想快速讨论的研究，标题是《长时间耐力运动中压力激素与睾酮的关系》。

The next study I wanna quickly talk about is entitled the relationship between stress hormones and testosterone with prolonged endurance exercise.

所以这个研究挺有意思的。

And so this one was interesting.

基本上，他们做了一个最大测试，也就是力竭时间测试，强度是通气阈的100%，这个阈值应该和乳酸阈非常接近。

Basically, they did a max test, time to exhaustion test, at 100% of their ventilatory threshold, which should be very similar to their lactate threshold.

结果你猜怎么着，受试者运动了大约84分钟，然后他们测量了22名有耐力训练的男性的睾酮、游离睾酮、总睾酮和皮质醇的反应。

And lo and behold, people exercised for about eighty four minutes, and then they looked at the response in testosterone, free testosterone, total testosterone, and cortisol in 22 Endurance trained males.

结果发现，正如你可能预料的，运动结束后睾酮水平立刻上升了。

And what they showed, as you might expect, is that the testosterone levels rose immediately after the exercise bout.

但这仅限于总睾酮。

But that was specifically only in the total testosterone.

当他们看游离睾酮时，实际上基线水平最高，然后逐渐下降，最终降低了50%。

When they looked at free testosterone, it was actually highest at baseline and then got progressively lower to the point where it was 50% lower.

从150，他们这里写的是什么，皮摩尔每升，一直降到运动后24小时的大约75皮摩尔每升。

It went from 150, what do they have here, picomoles per liter all the way down to about 75 picomoles per liter twenty four hours after the bout.

所以这意味着，是的，当你进行急性运动时，你的游离睾酮水平会反复受到抑制。

So what that means is that, yeah, when you exercise acutely, you're getting these repeated this repeated blunting of your free testosterone levels.

同样，在总睾酮方面，他们发现它，嗯，

And then similarly in total testosterone, they showed that it, hey.

运动后立即略有上升，但到24小时后，从15纳摩尔每升降到了10纳摩尔每升。

It went up a little bit immediately after exercise, and then by twenty four hours, it had gone from 15 all the way down to 10 nanomoles per liter.

然后看催乳素，它从5一路升到30，运动后24小时又降回5。

And then when they looked at prolactin, it went from five all the way up to 30, and then by twenty four hours post exercise, it went back down to five.

皮质醇从300纳摩尔每升升到700，运动后30分钟几乎翻了一倍。

Cortisol went from 300 nanomoles per liter all the way up to 700, so it nearly doubled by thirty minutes post exercise.

然后它又降回到基线以下。

And then it goes all the way back down to below baseline.

所以起始值大约是330，运动后24小时，它降到200以下，大概175左右。

So the start was about 03:30, and then post twenty four hours post exercise, it goes below 200 down to, like, one seventy five.

所以，基本上，他们展示的是，游离睾酮从运动前到运动后立即下降，再到运动后24小时，一直处于被抑制的状态。

So, basically, what they're showing is that the free testosterone really just drops from immediately post exercise from before exercise and then post exercise all the way to twenty four hours post, you see these depressions and free testosterone.

总睾酮略有上升，但到24小时又降回基线以下。

Total testosterone goes up a little bit and then goes back below baseline by twenty four hours.

催乳素和皮质醇基本上会飙升，然后在运动后二十四小时回落到基线以下。

Prolactin and cortisol basically spike and then go back below baseline by twenty four hours post.

所以，简单来说，这就像是对皮质醇的一个快速背景介绍。

And so that's kind of, like, for context, just quickly about cortisol.

这解释了为什么我们觉得运动能缓解压力。

That explains why it we think we know that exercise is stress relieving.

对吧？

Right?

短期内，是的，它会高于基线，但这是一种良性的压力反应。

In the short term, yeah, it goes above baseline, but this is a good stress response.

对吧？

Right?

皮质醇会分解游离脂肪酸。

Cortisol breaks down free fatty acids.

它还具有抗炎作用。

It it is anti inflammatory.

它是一种分解代谢激素。

It is a catabolic hormone.

皮质醇不一定就是坏的。

Cortisol is not necessarily bad.

它只是名声不太好。

It just gets a bad rap.

事实上，当我们研究用皮质醇类药物处理的免疫细胞时，它们在适当条件下会表现出类似血管生成的特征。

In fact, when we study immune cells treated with cortisol like drugs, they exhibit, like, angiogenic features under the right conditions.

所以我不会认为皮质醇全是坏处。

So I wouldn't necessarily think that cortisol is all bad.

所以运动后24小时，皮质醇水平从大约330一直降到175左右。

So by twenty four hours post exercise, cortisol, again, it goes from, like, three thirty all the way down to, like, one seventy five.

也就是说差不多降低了50%。

So it's roughly 50% lower.

基本上，在这项研究中，他们试图探究压力激素和雄激素之间是否存在某种关联。

And, basically, what they did in this study is they were trying to see if there's some relationships between your stress hormones and your androgen hormones.

他们观察到的一个有趣现象是，运动后三十分钟的皮质醇峰值水平与总睾酮水平呈负相关。

And one of the interesting things that they observed is that there was a negative relationship between peak cortisol levels at thirty minutes post exercise versus total testosterone.

而催乳素与总睾酮或游离睾酮之间没有显著关联。

Now there were no significant no relationships between prolactin and total or free testosterone.

但他们得出的结论是，这确实支持了一个假说，即耐力训练的跑步者中，低静息睾酮水平与压力激素（特别是皮质醇）之间存在某种联系。

But what they concluded is that it does give credence to the hypothesis that there's some linkage between low resting testosterone and endurance trained runners and stress hormones, specifically cortisol.

这挺有意思的，因为后来哈克尼医生直接研究了睾酮和皮质醇之间的关系。

And this is kinda interesting because later what they actually do what doctor Hackney does is he directly looks at the relationship between testosterone and cortisol.

我得找到那篇论文。

I've gotta find that paper.

好的。

Alright.

找到了。

I found it.

论文标题是《男性耐力运动员中睾酮水平的下降并不代表运动表现下降》。

It's called reductions in testosterone are not indicative of exercise performance decrement in male endurance athletes.

这就是我刚才提到的那篇论文，它有点像一篇简短的通讯文章。

So this is the paper that I was referencing that and this is kind of like a short communication.

可能是一封致编辑的信，或者是一篇评论文章，我想应该是这样。

Maybe it's a letter letter to the editor or a commentary, I guess, is what it is.

但这正是我提到的那篇，讲的就是这种关系。

But this is the one I was referencing that is talking about this relationship.

而且，他们引用了《衰老男性》杂志最近发表的一篇文章。

And And so, so, you you know, know, they they reference reference a recent publication in the aging male.

他们认为耐力训练会影响成年男性循环睾酮水平，特别是长期耐力训练会增加雄激素缺乏的风险。

They characterize endurance training as impacting the levels of circulating testosterone levels in adult men, specifically that chronic endurance training leads to an increased risk of androgen deficiency.

不过有趣的是，当他们真正查看数据时，确实发现从第五周到第十八周，睾酮水平大约下降了25%到45%。

What's interesting, though, is when they actually, like, look at the data, they did find that testosterone levels from weeks five through 18 were roughly 25 to 45% lower.

上面说基线水平大约是每升21.6纳摩尔。

It says that baseline was about 21.6 nanomoles per liter.

然后我们看看。

And then let's see.

它一路降到了每升12.7纳摩尔。

It goes all the way down to 12.7 nanomoles per liter.

所以低了很多很多。

So much, much lower.

然后当他们从第14周到第18周停止训练时，它逐渐恢复到基线水平，但仍然偏低。

And then when they detrained from weeks fourteen to eighteen, it gradually returned towards baseline, but it remained decreased.

所以这表明，当你进行这种高强度的训练时，它会抑制你的雄性激素。

So this suggests that when you're doing this high level of training, it's gonna depress your androgen hormones.

但当你稍微休息一下，这些水平又开始回升。

But then when you kind of lay off for a little bit, the levels start to increase again.

有趣的是，跑步成绩在第4周、第8周、第12周和第16周都比基线水平有了显著提高。

What's interesting is that running performance increased or improved significantly from baseline at weeks four, eight, twelve, and sixteen.

对吧？

Right?

每次测试的成绩都比之前提高了大约18%。

It was roughly an 18% improvement at each respective performance test compared to the prior perform.

这说明，尽管静息睾酮水平会显著下降，甚至有些达到临床上的雄激素缺乏标准，但跑步成绩仍然可以提升。

So what this indicates is that while you can experience significant reductions in resting testosterone with some reaching the clinical criteria for androgen deficiency, you can still increase your running performance.

也就是说，即使睾酮在下降，跑步表现并没有变差。

Like, even though testosterone was dropping, there were no decrements in running performance.

实际上，结果恰恰相反。

In fact, the opposite occurred.

所以这只能说明，情况比我们想的要复杂得多。

And so it just suggests that it's more complicated than you think.

并不是简单的“睾酮低，表现就差”这样的关系。

It's not as simple as testosterone low performance bad.

对吧？

Right?

在这项大规模训练研究中，David Hooper和Anthony Hackney在一篇评论里指出了这一点。

In this massive training study, and this is a commentary from David Hooper and Anthony Hackney, they're kind of pointing this out.

他们在那篇文章里引用的另一篇论文，是一封致编辑的信，其中显示，在耐力训练的男性中，雄激素缺乏的患病率在整个生命周期中都在增加。

And another paper that they referenced in that paper is a letter to the editor that kind of showed that there's this increased prevalence of androgen deficiency in Endurance trained males across the lifespan.

这篇论文很有意思，因为我本人就是这项研究的参与者。

And this paper is interesting because I was actually a participant in this study.

我在北卡罗来纳大学的时候，艾米·莱恩和哈克尼博士都在那里。

So when I was at UNC, Amy Lane was there as well as doctor Hackney.

结果呢，我当时是个硕士生，他们正好需要人帮忙做这个研究。

And lo and behold, I was a master's student, and they needed somebody to do the study for them.

所以我就自告奋勇了。

So heck, I volunteered.

基本上，他们就是让我们在跑步机上锻炼。

And basically, they just had us exercise on a treadmill.

他们观察了我们平时的跑步习惯。

They looked at our habitual running.

就是看我们平时怎么跑、跑了多久。

It's kinda like how what we were doing, how long we'd been doing it.

标准是过去一年里，每周训练超过七小时，或者每周跑超过八十公里的人。

And the criteria was anybody who trained more than seven hours a week or greater greater than 80 kilometers per week for the past year.

然后他们尽量在年龄、BMI这些方面进行匹配。

And then they tried to match for age, BMI, all that stuff.

所以他们基本上找了年龄匹配的对照组，这其实挺难做到的。

So they had basically age matched controls, which is pretty hard to do.

接着他们让我们禁食，然后做了一堆运动。

So then they had us fast, and then they had us do a bunch of exercise.

他们发现，所谓的雄激素缺乏症，在跑者中有百分之十五的人存在，而对照组只有百分之五。

And what they found is that androgen androgen deficiency, as they call it, was present in fifteen percent of the runners and only five of the controls.

所以，这再次印证了一个观点：当你长时间高强度训练时，睾酮水平很可能会下降。

So, again, this supports the idea that at some level when you're training for a long time really, really hard, you're probably gonna have lower testosterone levels.

还有另一篇论文，或者说类似的研究方向，他们展示了实际的数据。

And then there was another paper or rather kind of along the same lines of research where they show the actual data.

他们发现，跟对照跑者相比，如果你只进行了一年的耐力训练，你的睾酮可能只会下降百分之十。

And what they show is relative to the control runner, if you've only had one year of endurance training, you might only be ten percent.

可能只会下降百分之十。

You might only have a ten percent reduction in testosterone.

两年耐力训练，这个比例就降到大约15%。

Two years of endurance training, that goes to about 15%.

到了五年耐力训练，睾酮水平会降低30%。

By five years of endurance training, it goes 30% lower.

十年的话，降低35%，对吧？

Ten years, 35 Right?

所以，随着时间推移，效果会逐渐递减。

So there's kind of these diminishing returns with time.

实际上，到十五年时，只降低了30%。所以，这意味着头两年你会看到大约一半的下降幅度。

And then actually by fifteen years, it was only 30 per So, really, what this means is that in the first two years, you're gonna see about half the drop that you would see.

而到了五年，你的睾酮水平就会降到最低，差不多就是你再训练十年能达到的水平。

And then by five years, your testosterone is gonna be as low as it is, you know, if you're gonna train for the next ten years.

他们还发现，不出所料，年龄越大，睾酮水平低的可能性就越高。

And they also showed that, as you might expect, the older you get, the more likely it is that you're gonna have low testosterone levels.

所以，这既跟训练年限有关，也受到自然衰老过程的影响。

So it's it's both with regard to training age, but also there's an effect of just the natural aging process as well.

所以总的来说，有足够的证据表明，如果你长期保持较高强度的训练，你的雄激素水平就会有一定程度的下降。

So all this to say, like, there is enough of a body of evidence that if you're training at even a reasonably high level for a consistent duration of time, you're gonna see some degree of androgen deprivation.

这里做个对比，就是年龄的影响和训练的影响。

And just like for context, the effect of age, right, or the effect of training.

训练年限越长，跑步者雄激素缺乏的比例就越高。比如，如果你训练不到十年，这个比例可能是百分之六——这是另一项研究的数据——但如果训练超过十年，比例可能就达到百分之三十二了。

So the increasing years of training does escalate the prevalence of androgen deficiency in runners such that if you've been doing it for less than ten years, it might be this isn't a different study, but six percent versus if you were training for more than ten years, it might be thirty two percent.

对吧？

Right?

所以雄激素缺乏有一个临界点。

So there's a cut point for androgen deficiency.

如果你训练超过十年，很可能已经出现了一定程度的雄激素缺乏。

And if you've been training for more than ten years, chances are you're probably having some degree of androgen deficiency.

另外，年龄也有影响。如果你超过45岁，不管训练不训练，雄激素缺乏的比例大约在百分之十四左右。

And if you're older so if you're older than 45 years of age, then androgen deficiency is prevalent in about fourteen percent of people over the age of 45 regardless of training.

而如果你不到45岁，出现这种情况的可能性就小得多。

And then if you're less than 45, you're much less prone to it.

只有百分之七，跟训练不到十年的人差不多。

It's only seven percent, which is similar to people who have been training for less than ten years.

这两件事是有关联的，但我只是想大致说明一下雄激素缺乏的情况。

Now these two things are correlated, but I'm just trying to paint the picture of, like, androgen deficiency.

到现在为止，我讲了很多关于男性和雄激素缺乏的内容，但我想快速聊聊女性的睾酮水平。

So at this point, I've talked a lot about men and androgen deficiency in men, but I wanna talk quickly about the testosterone levels in females.

有一项研究让我想到，是斯蒂芬·伯曼的一篇论文。

And one study that comes to mind is a paper by Stephane Berman.

可能我名字说错了。

Maybe I said it wrong.

应该是斯蒂芬·伯曼，发表在2021年的《英国运动医学杂志》上。

Might be Stephane Berman in the British Journal of Sports Medicine published in 2021.

这篇论文主要研究了2100名男性和女性的睾酮水平。

And this paper basically looked at testosterone levels in 2,100 individuals, both male and females.

他们发现，男性短跑运动员的睾酮水平高于其他项目的男性运动员，这跟我刚才说的是一致的。

And what they showed is that in male sprinters, they had higher testosterone than in male males and other events, which makes sense based on what I just said.

对吧？

Right?

如果这样的话，这可能跟训练量有关。

If you're this could be related to the training volume.

对吧？

Right?

不是说短跑运动员训练量不大，而是他们做的训练类型不太容易导致睾酮水平下降。

Not that sprinters aren't doing a lot of training, but the type of training that they do is much less conducive to low testosterone levels.

对吧？

Right?

因为那样会影响表现。

Because that would hurt performance.

他们观察女性时发现，在自由睾酮水平最高的女性中，她们在400米、400米栏、800米、链球和撑杆跳项目上表现更好，差距在2.7%到4.5%之间。

Now when they looked at the females, what they showed is that in females with the highest free testosterone turtile, they tended to perform better in the 400 meter, 400 meter hurdles, the 800 meter, the hammer throw, and the pole vault with margins between 2.74.5%.

所以这个模式——这才是最有趣的部分。

So this pattern this is the interesting part.

这种模式在男性运动员中并没有出现。

This pattern was not found in any of the male athletic events.

所以这意味着，如果——再说一次，这全都是相关性分析。

So what this means is that if and, again, this is all correlative.

这不是因果关系。

This is not causative.

实际上，他们后来还发了一篇论文的更正，特别说明这只是相关性。

And in fact, they actually have a correction to the publication where they specify that this is all correlative.

不是因果关系。

It's not causative.

他们明确表示，我们意识到论文中的某些表述可能暗示了因果关系，容易让人误解，所以应该修改为：高游离睾酮水平的女性，其运动表现优于低游离睾酮水平的女性，而不是说这带来了显著的竞争优势。

In fact, they state that we recognize that statements in the paper could have been misleading by implying a causal interference, but they should amend the statement to be that high free testosterone levels in females were associated with higher athletic performance over those with low free testosterone instead of stating that it provided a significant competitive advantage.

对吧？

Right?

所以他们的意思是，这是科学探索的第一步，通过回顾历史数据来研究睾酮暴露是否可能提高或增强年轻健康女性的身体表现。

So their point is that this was a first step in a scientific sequence to explore the historical and retrospective data whether or not testosterone exposure could increase or enhance physical performance in young healthy women.

其实，他们真正想做的就是开启这个研究过程，而他们通过这次大规模的相关性分析迈出了第一步。

I mean, that's really what they're trying to do, and they're just trying to start that process, and they did that by doing this massive correlative analysis.

但是，在体育界围绕高睾酮水平女运动员是否有资格参加女子组比赛引发诸多争议的背景下，这篇论文在伦理和方法论上都可能面临不少批评。

But in the wake of a lot of things going on in sports around the eligibility of female athletes with high levels of testosterone to compete in the women's category, you know, this paper had a lot of potentially ethical and methodological criticisms.

不过，那并不是这篇论文的重点。

But that wasn't the point of the paper.

这篇论文的重点只是想确认一点：嘿，

So the point of the paper is just to establish that, hey.

女性睾酮水平与某些短距离项目表现之间存在相关性。

There's a correlation between testosterone levels in females and performance in some of these more short shorter distance events.

所以这意味着，嘿，

So what that means is that, like, hey.

对于女性来说，如果你是400米或800米跑选手，某些补充剂可能对你更有好处。

In females, maybe some of these supplements are more beneficial if you're a 400 or 800 runner.

当然，很明显，无论男女，一旦开始服用睾酮补充剂，肌肉量增加，这对长跑可没什么帮助。

Now, obviously, if you start taking a sup a testosterone supplement, whether you're male or female, and you start seeing, like, increases in muscle mass, that's not gonna help you for distance running.

这不会对你有帮助。

It's it's not gonna help you.

我知道现在混合型运动员中有一股很大的潮流，认为你可以两者兼顾。

I know there's a huge movement right now among hybrid athletes saying that, you know, you can do both.

你可以有很多肌肉，同时也能跑步。

You can have a lot of muscle and run.

这确实是真的。

And that's true.

你可以两者都做，但这并不意味着你在那种条件下能发挥出最佳水平。

You can do both, but that doesn't mean that you're gonna perform the best under those conditions.

一个典型的例子就是看看特鲁伊特·海恩斯。

And a classic example is, like, look at Truett Haynes.

不管你喜欢他还是讨厌他，如果你看看他过去几年的身体成分，你会发现他明显减少了很多肌肉量。

Love him or hate him, if you look at his body composition over the past few years, you can see that he has lost a significant amount of muscle mass.

现在他仍然又矮又壮，但他看起来更像一个跑步者，而不是一个举重运动员了。

Now he's still, like, short and stocky, but he looks a lot more like a runner now than he does a lifter.

说实话，如果我见到他，我不会觉得这家伙是个混合型运动员。

In fact, you know, if I saw him, I wouldn't see him and say to myself, like, oh, that that guy's a hybrid athlete.

我会觉得他是个跑步的。

I'd say that guy's a a runner.

他的体型就是跑步运动员的样子。

He's built like a runner.

他看起来就像个跑步的。

He looks like a runner.

我不知道他具体多高多重，也不清楚他的任何数据，但他那身形一看就是经常跑步的人。

I don't know what it's like, height and weight or I don't know any of his metrics, but he has the the looks of someone that runs.

好，我们继续往下说。

So moving on.

我们聊了很多关于不同睾酮水平的话题，简单来说就是，嘿。

We've talked about a lot of different testosterone levels and just that, like, hey.

在耐力运动员中，他们的睾酮水平偏低。

In in Endurance Athletes, they have low testosterone.

其中我经常想到的一个问题是维生素D的补充。

And one of the things that I think comes up a lot is vitamin D supplementation.

2019年发表了一篇荟萃分析。

And so there was a there was a meta analysis that was published in 2019.

别让我念作者的名字，但第一作者是Helam Marnani。

And don't ask me to say the author's name, but the first author is Helam Marnani.

Helam Marnani。

Helam Marnani.

这些名字我总是念不好，但文章标题是《维生素D补充对男性雄激素谱的影响》。

It's always hard for me to say these names, but it says the effect of vitamin D supplementation on the androgenic profile in men.

这很有意思，因为根据2008年发表的一些论文，他们提出全球有超过十亿人缺乏维生素D。

And this is interesting because, I guess, according to some papers published in 2008, they suggested that over one billion people in the world suffer from vitamin D deficiency.

后来也有一些论文反驳这个观点，说实际情况可能没有最初那篇论文说的那么普遍，但这基本上就是支持这篇论文的证据。

Now there have been some papers coming back at this and saying, like, it's not, you know, as prevalent as that original paper might suggest, but that's kinda was the evidence to support this paper.

维生素D有趣的地方在于它被认为是一种开环类固醇，这类固醇分子的特点是，用他们的话说，有一个断裂或裂开的环状结构。

And what's interesting about vitamin D is it's considered a cecosteroid, and these are a subclass of steroid molecules characterized by, quote, unquote, a broken or cleaved ring structure.

而维生素D是最典型的，可以说是原型性的开环类固醇。

And vitamin D is the most, like, kind of the prototypical cecosteroid.

维生素D之所以有趣，是因为它看起来很像类固醇激素。

And vitamin D is interesting because it looks a lot like a steroid hormone.

类固醇激素通常都有这种环状结构。

So steroid hormones generally have this ring like structure.

它们是疏水性的，所以能直接穿过细胞膜，在细胞内部与激素反应元件结合。

They're hydrophobic, so they they go right through cell membranes, and they bind directly to hormone response elements inside the cell.

当你观察维生素D时，会发现它看起来非常相似。

And when you look at vitamin D, it kind of looks very similar.

维生素D实际上有各种各样的功能。

Now vitamin D has, like, all of these different functions.

说实话，在读过一些相关论文后，我现在不服用维生素D了。

I truthfully don't take vitamin D after reading some of these papers.

我还在考虑这件事。

I'm thinking about it.

你知道，传统上认为它在钙调节和骨骼健康中扮演重要角色。

You know, it's traditionally been thought of as playing a significant role in calcium regulation and bone health.

它在钙稳态中具有调节功能。

It has regulatory functions in calcium homeostasis.

所以很多人把维生素D和应力性骨折、骨质疏松或骨量减少联系起来看。

So a lot of people have kind of looked at vitamin D as it relates to, like, stress fractures or osteoporosis or osteopenia.

而且我认为，如果你缺乏维生素D，这些情况确实可能相关，这方面的证据很充分。

And I think there's, you know, substantial evidence that if you're deficient in vitamin D, these things might be relevant.

但维生素D有意思的地方在于，它似乎对男性的激素生成有影响。

But what's interesting about vitamin D is that it seems to have effects on hormonal production in males.

比如，睾酮是一种合成代谢激素。

For example, testosterone is an anabolic hormone.

对吧？

Right?

而睾酮是由莱迪希细胞在黄体生成素刺激后产生的。

And the these testosterone is made by Leidig cells after they're stimulated by luteinizing hormone.

所以逻辑是这样的：因为睾酮水平会随年龄增长而下降，并且与肌肉骨骼问题、肌肉减少症和骨量减少有关，所以值得提一下，维生素D缺乏和睾酮缺乏在并发症方面其实非常相似。

So the rationale is that because testosterone decreases with age and is associated with musculoskeletal problems, sarcopenia, and osteopenia, that it might be worth mentioning that vitamin D and testosterone deficiency in general have very similar complications.

而且，之前的一些研究表明，维生素D与男性的雄激素水平密切相关，这让他们觉得，嘿。

And the fact that vitamin D is strongly associated with androgen levels in men, like by some previous studies, led them to think that, hey.

这两者之间可能有关联。

These two things might be related.

所以当他们研究补充维生素D对总睾酮的影响时，发现效果非常有限，我甚至可以说微乎其微。

So when they looked at vitamin D supplementation and total testosterone, there were very modest, I would say even trivial effects.

他们计算标准化均值差时，数值大约是0.2，而且没有统计学意义。

So when they did the standardized mean difference, the value was about 0.2, and it wasn't statistically significant.

确实有趋势显示，服用维生素D后总睾酮水平略有升高，但总体来看，效果并不显著。

There was a trend to see kind of slightly higher total testosterone when people took vitamin D, but overall, the effects were not statistically significant.

他们做的一个亚组分析显示效果稍微大一点，就是当他们观察SHBG（性激素结合球蛋白）时，这是一种由肝脏产生的蛋白质，会附着在睾酮和雌激素等性激素上，从而控制它们在体内的活性水平。

The one subgroup analysis that they did that kind of showed a little bit of a larger effect is when they looked at SHBG, which is sex hormone binding globulin, which is a liver made protein that attaches to sec hormones like testosterone and estrogen to control their active levels in the body.

所以这并不代表实际的游离睾酮，但它暗示了，嘿。

So it's not the actual free testosterone, but it kinda suggests that, hey.

维生素D可能对这些激素水平有影响。

Vitamin D might have an influence on these hormonal levels.

所以，说到维生素D补充剂，其实对很多补充剂来说，我的一般原则是：如果你想买，觉得买得起，又觉得可能有用，那就吃吧。

So And when it comes to vitamin D supplementation and and really for a lot of you supplements, I think my general rule of thumb is, like, if you wanna get it and you think it you can afford it and you think it might help, then go ahead and take it.

你知道，它不会害你。

You know, it's not gonna hurt you.

不过它是一种脂溶性维生素，这意味着如果吃太多，确实可能有害。

Now it is a fat soluble vitamin, which means that it can actually hurt you if you take too much of it.

所以你得注意用量。

So you need to be careful about how much you're taking.

但有一些证据表明，它可能影响你的睾酮水平。

But there is some evidence that says, like, it might influence your testosterone.

至于直接研究睾酮治疗对运动表现的影响，我在男性中其实没找到相关研究。

Now in terms of studies that look at testosterone treatment directly on performance, I actually couldn't find any in men.

有一项针对女性的研究显示，是的，它可以提升表现。

There was one study in women that showed that, yeah, it can improve performance.

我不想深入讲这些，因为事情会变得非常复杂。

I don't really wanna talk about these just because of the fact that it gets very complicated.

对吧？

Right?

而且这已经超出了我的专业范围。

And this is, like, outside of my scope.

所以，这期播客的主要目的就是想告诉大家，嘿。

So, you know, the main purpose of this podcast is just to say that, like, hey.

男性在大量训练时确实会出现一定程度的雄激素缺乏。

Men do experience some level of androgen deficiency when they do a lot of training.

我们知道这些雄激素变化在女性身上也会发生。

We know that these androgen changes happen in women.

在女性身上更容易察觉，因为她们通常会出现月经失调、闭经或者停经等症状。

It's a lot easier to detect because they typically exhibit some form of menstrual dysregulation or amenorrhea or loss of their period.

而男性呢，就没有这么明显的症状。

Whereas in men, you know, they don't have such a visible symptom.

所以这正好说明了，你看，

So it just kind of supports the fact that, hey.

大量进行耐力训练确实会影响你的性激素。

Endurance training, when you do a lot of it, influences your sex hormones.

这其实挺合理的。

And this makes sense.

对吧？

Right?

对，从进化角度看，繁殖和延续后代确实是个非常重要的功能。

Like, yeah, it's a really important function from, like, an evolutionary perspective and re reproducing and perpetuating offspring.

但说到底，如果你需要生存，又在努力保存能量，那么对女性来说，停止那个会消耗宝贵营养的过程，反而有助于生存。

But at the end of the day, like, if you have to survive and you're trying to preserve energy, then probably as a female cutting out the process that is going to purge your body of valuable nutrients is gonna be helpful for survival.

对男性来说，过程类似，只是可能没那么明显。

And in terms of men, similar process, albeit, like, maybe a little bit less pronounced.

所以，如果你想吃睾酮补充剂，那也可以。

So, you know, like, if you wanna take testosterone supplements, you can do it.

有一些研究，我觉得我看到的最好的研究是关于喜来芝的，那是一种类似喜马拉雅黑焦油的东西。

There are some studies on I think the the best study I found was on shilajit, which is like a Himalayan black tar or something like that.

说实话，我对它了解很少。

To be honest, I know very little about it.

我知道它在社交媒体上又火起来了，但我也知道它能把你的睾酮水平提高，大概游离和总睾酮加起来能提高20%左右，其实真没多少，尤其是考虑到我之前提到的运动反应，一次运动后游离或总睾酮就能提高那么多，甚至更多。

I know that it's popular again on social media platforms, but I know that it can raise your testosterone levels by, I don't know, I think, like, free in total, maybe, like, 20%, which is really not that much, you know, especially when you consider the kind of exercise response that I mentioned earlier where free testosterone after or total testosterone after a exercise bout can go up by that much or more just with exercise.

所以你的睾酮每天都会因为昼夜节律、运动和举重而波动那么多。

So your testosterone's fluctuating that much on a daily basis just with, like, diurnal rhythms and exercise and weight lifting.

所以我觉得，我不确定它有多大效果，但也许你能找到适合自己的最佳浓度，比如，嘿。

So I just like I don't know how impactful it is, but maybe there is some optimal concentration that you can figure out for yourself where, hey.

它是可以调节的。

It's titrated.

你不会增加肌肉量，但能加快恢复。

You're not gonna gain muscle mass, but you're gonna increase recovery.

我不知道这是不是真的，或者到底存不存在。

I don't know if that's even a thing or if it it exists.

如果有人找到相关论文，请告诉我，因为我觉得那会很有意思。

If somebody finds a paper on it, please let me know because I think that would be really interesting.

但我觉得，很多理由都是说它有助于恢复。

But I think that's, like, a lot of the rationale is that it's gonna help with recovery.

当然，从传闻来看，可能确实有些依据，但我对此了解很少。

Again, anecdotally, maybe there's some stuff out there, but I know very little about it.

好了，这期关于睾酮水平和训练的短播客就到这里。

So, anyways, that concludes this short little podcast on testosterone levels and training.

下一期播客我会聊聊过度训练，因为我觉得这个话题衔接得很好。

I'm gonna talk a little bit about overtraining because in the next podcast because I think this leads well into it.

菲尔·拉森做的一些关于过度训练的研究非常有意思。

And, some of the studies that Phil Larson has done are very interesting as it relates to overtraining.

另外，我还想录一期关于最大摄氧量的播客，讲讲为什么你不需要达到最大摄氧量。

Also, still wanna record a podcast on v o two and why you don't need to hit v o two max.

比如，你不需要以最大摄氧量的速度跑步才能达到最大摄氧量。

Like, you don't need to run at velocity of v o two max to hit your v o two max.

实际上，你可以在低于最大摄氧量的速度下跑步，仍然能达到那个水平。

You can actually run sub v o two max and still get there.

我发了一封相关的邮件通讯，如果你还没看的话可以去看看，因为里面会详细讲这个。

I dropped a newsletter there so you can check that out if you haven't done so already because it'll it'll cover that.

和往常一样，如果你对接受指导感兴趣，可以在 endurance laboratory.com 上在线申请。

But as always, if you're interested in being coached, you can apply online at the endurancelaboratory.com.

至少我们可以提供一次免费咨询。

And at the very least, we can do a free consult.

我可以和你聊聊，看看什么方案最适合你，如果合适的话。

I can talk with you, and we can figure out what fits best for you if it's a good fit.

我们一直在努力扩大团队，而且过去几周我们取得了一些非常不错的成绩。

We're always trying to grow the group, and, we've got some really good performances over the last few weeks.

简单提几个例子，我们有一位女选手。

Just to highlight a few really quick is we had one woman.

她的一英里成绩提高了大约五到十秒。

She PR ed the mile by about five or ten seconds.

还有一位跑友，五公里成绩提高了大约十五秒。

We had another guy PR ed the five k by about fifteen seconds.

另一位跑友，四十二岁，一英里跑了差不多五分整。

We had another guy run right around five flat for a mile at 42 years of age.

他是2006年5月来到这里的。

He came here in 05/2006.

当时比赛他排第十九名。

He was nineteenth in the race.

所以，我觉得如果他再试一次，真的有可能跑进五分钟以内。

So, you know, I feel like if he had another crack at it, I really think I really think he could, like, get the the sub five.

给他加油打气还挺有意思的。

Just kinda fun to, like, cheer him on and stuff.

另外，我们在罗利附近早上有个小组聚会，现在开始有一些人聚在一起训练了。

And then we had, you know, we got a group meeting out in near Raleigh in the mornings, and we were starting to get, like, some traction with some people getting together.

然后我又发现一位运动员，正准备进行一次计时测试。

And then I found another athlete who's getting ready to rip a time trial.

他希望能代表印度国家队参加800米比赛。

He's hoping to make the national team for India for the 800.

所以，是的。

And so yeah.

我也不太确定。

I don't know.

有些激动人心的事情正在发生。

Some exciting stuff going on.

跟着运动员们一起关注他们的进展挺有意思的，不管是精英选手、次级精英还是高中生，我都很享受这个过程。

It's fun to, like, follow along with the athletes, whether they're elite or sub elite or high school, But I've really enjoyed it.

所以，如果你有兴趣聊聊你的训练，随时可以联系我们，在耐力实验室网站上申请。

And so if you're interested in just talking about your training, you can always reach out, apply at the Endurance Lab.

页面底部有一个小小的申请按钮。

There's a little apply button at the bottom.

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