Chael P. Sonnen
When trying to treat one’s pathology, which in this case is hypogonadism, you can’t just say, “the man has small balls. Let’s give him testosterone.” With my luck the patient would have an insidious tumor in his pituitary or prostate and thus I would be throwing fuel on the fire. One must figure out if the problem is a cancerous tumor, non-cancerous tumor, something negatively affecting the precursor hormones, something affecting the organs that produce the precursor hormones, something affecting the hormones that maintain the organs that produce the precursors...yada yada yada. Once all this is determined via testing of blood levels and possibly imaging, then a treatment plan can be made.
It’s also worthy to mention a few things that testosterone effects: Obviously muscle formation, protein formation, bone growth and calcium retention, basal metabolism, RBC levels, electrolyte and water balance. But what is more amazing is it’s mechanism of action and production.
To put it very superficially, testosterone is controlled by some intricate mechanisms. It’s secretion takes place in the testes by interstitial cells called Leydig cells. Other androgenic hormones, e.g. dihydrotestosterone, androstenedione, are also produced in the testes. Testosterone just so happens to be produced more abundantly than the other ones, which is why it’s so important to maintain. Well, after testosterone is secreted from the testes about 97% does one of two things: the first would make you want to shoot yourself and the second half will move into the blood stream. The testosterone is then is either transferred to the tissues or is degraded into inactive products that your body shoots out the waste exits. The part that stays in the tissue is converted into dihydrotestosterone, especially in target cells in the prostate. Some actions of testosterone are hella dependent on this conversion whereas others are not. (This is why I wanted to blow my brains out in endocrinology. There are always exceptions and special rules to keep in mind. And this is just one hormone.) Now the testosterone that doesn’t go into the tissue and is going to be thrown outta the body, is converted really fast-like in the liver. The product of the conversion is androsterone and dihydroepiandrosterone. From here these products are excreted either into the gut by way of liver bile or into urine via the kidneys.
The precursors of testosterone that I mentioned above that regulate its production is LH. LH=luteinizing hormone. Now LH production is influenced by gonadotropin-releasing hormone or GnRH. GnRH stimulates the front part of the pituitary gland to secrete LH and another hormone called FSH (follicle stimulating hormone.) The LH is the primary stimulus of testosterone secretion. The FSH is what stimulates the beginning formation of our baby makers/sperm.
So since the testosterone secretion is stimulated by LH from the pituitary gland, the quantity of testosterone secreted increases in direct proportion to the amount of LH available. What does it all mean Bazil? There’s a balance to be kept between LH and testosterone. Also, there’s a feedback if there’s too much testosterone in the body. This will cause the pituitary to say, “chill out on the production of LH!” STAY WITH ME!!! Whenever the causation of said increases of testosterone ceases then the front part of the pituitary will need to be turned back on to produce appropriate amounts of LH to form testosterone. This shut down usually is caused by too much testosterone, which has a negative affect on the hypothalamus’s secretion of our friend GnRH. This in turn causes decreases in secretion of both LH and FSH…in the front part of the pituitary gland. This DECREASE in LH decreased the secretion of testosterone in the testes. Someone wisely mentioned last week about the negative feedback loop involved in this matter. To take it a little deeper, whenever the secretion of testosterone becomes too great, the negative feedback effect occurs via the hypothalamus and front pituitary gland and this reduces the testosterone secretion back toward normal operating levels. Oppositely, too little testosterone allows the hypothalamus to secrete huge amount of GnRH, which increases the front pituitary’s LH and FSH secretion and as a result increases the testicular testosterone secretion.
It’s also interesting to mention when normal quantities of testosterone are injected into a castrated adult male, the number of RBC’s/cubic mm increases 15-20%. Normally men have 700,000 more RBC’s/cubic mm than the average woman…emphasis in average. This leaves out Cyborg.
My point in spending ten minutes refreshing myself over said mechanism via my lovely Bible (Guyton and Hall Medical Phyisology) and spending thirty minutes of my life writing this out is that improper testosterone levels, regardless of its etiology, has wide reaching effects on the body. The body’s function(s) is like any other machine. If it has to work harder than normal to function, then it most likely will wear out before its time. The smoother something works the longer it should work. Try going a year without changing your car’s oil, transmission fluid, or antifreeze. Let us know how that works for you.
If Chael were to die from natural causes his death certificate wouldn’t read, “Cause of Death: Hypogonadism, Secondary to Juicing.” He would probably die from some form of organ failure. Again, there’s more going on than merely low testosterone levels.
It’s pure speculation, however not improbable that Chael has taken some drug(s) or supplements, in addition to all the years of torture from training and weight cutting from his younger years, which has taken him down the road to where he is today. It should also be noted that there are legal options that can have the same effect on one’s testosterone production and secretion as synthetic hormones. This occurs especially around the Olympic season when chemists come up with designer drugs that skirt the rules.
To make a long story long, Chael isn’t BS’ing when he says he could die from non-treatment. It might not kill him today, this week, this month or this year, but it would kill him before his time. Waiting to begin analogous treatments when other metabolisms begin to fail isn’t healthcare. Waiting until your sick to receive treatments is called sick care. Maintaining a healthy lifestyle to the best of your ability with the cards that you’ve been dealt is healthcare. Though it’s clichéd, prevention is the key. And though Chael already has this pathology, it would be illogical to continue down that road leaving metabolic levels unchecked, which would open other can(s) of worms.
Last edited by _DCdoctr_; 07-03-2012 at 07:30 AM.
^ Awesome post. Should be on your sig as your latest productive post!
Mucho respecto, compadre.
I hope it doesnt happen obviously but just because someone is pissed doesn't mean squat in MMA. It didn't do much for Sabral when he fought Liddel nor did it help Rampage beat Griffin.
I hope Sonnen gets the worse beat down in his lifetime but im not writing him off because of TRT abuse let alone Silva's apparent rage.
Glad technology did not beat you this time around.
That may be true, but I dont see the relevance.
You may be a doctor and I mean no disrespect, but that has no more meaning then the countless theories about what is really going on... as you are not his personal doctor..
It is bad enough that he is allowed that exemption in the first place, but considering he was caught abusing it.... He deserves the skepticism around his case.
Also how many other stories have you heard of people being forced to give up their dreams because of a rare disorder or what have you... Im not sure im buying the hypothyroidism thing... but even at that... If it were another sport... say baseball it wouldn't be allowed anyways.
Sorry, we feel bad for your situation, but you still cant use it. As it would open up the door for more cases of athletes conveniently "needing" certain PEDS.
Most of the testing systems out there in sports are a joke, but one thing they at least do well is have a no tolerance policy... Weather you need it or not.
Like I said, I doubt that is even the case in the first place. but if it is, it isnt like someone is telling him to go away and die... he just cant do that and compete in mma at the same time.... not fair to the other fighters...
Another part of the equation is the allowable levels, 6 to 1 is actually a very generous allowable level for TRT patents in MMA. The allowable levels and average levels dont exactly match up... I guess their "illness" could turn out to be an advantage...
Its good to see a knowledgeable post doctor. We just need to understand that things are very different when talking about somebody is competing in a contact sport... His advantage could ultimately turn into someone else's harm...
great post Doc! i was even able to follow it for the most part (minus the specific hormones) just wanted to give you a pat on the back for the great post
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