Editor’s Note: There is such as thing as working out and dieting too much…
A 22-year-old man presented with lack of libido and erectile dysfunction of 4 years duration for evaluation. Past medical history was remarkable for fat restriction with regular engagement in body-building exercises. Physical examination was normal without any signs of hypogonadism. Laboratory work-up showed low total and high-density lipoprotein cholesterol with low total and bioavailable testosterone concentrations (Table). Gonadotropin levels were within normal ranges. Sperm analysis showed a low amount of live spermatozoids, 88% of which had severe morphological impairment with head defects. Brain magnetic resonance imaging was normal. Testosterone treatment was recommended. The patient insisted on nutritional consultation before hormone therapy initiation. Food records confirmed a very low fat intake: 2260 calories, 170 g protein, 350 g carbohydrates, and<20 g fat daily. Body composition demonstrated 4% body fat... To read this article in its entirety, please visit our website.
— — Aviva Shemesh, RD, MsC, Ronit Endevelt, RD, PhD, Yishai Levy, MD
This is an article in press on The American Journal of Medicine website.
