I know there are a lot of folks in this forum who are knowledgeable in analyzing blood test values, so I thought this might be a good place to ask this. Pardon the long, drawn out story, but I figured some background might be in order. If you don't want to or need to read my life's story, just skip to the row of asterisks for the pivotal question.
When I was younger, I was an amateur competitive cyclist. I was never very fast but I got hooked on the social aspects of being a racer, and the feeling of immortality I got from the health benefits of being an endurance athlete. I used to joke that the only way I'd ever manage to be an elite racer in my age group was to outlive all the guys who were faster than me, so my ambition was to be the world's oldest living competitive cyclist. But the racing kept me skinny, and the dietary concessions I made to my cycling performance needs kept my BP and cholesterol extremely low.
About my mid-40s, I was overtaken by life and no longer managed to dedicate the enormous blocks of time to training I needed to keep my weight in check. I've never been much one of to cut back on my intake, I just rode more. But that plan failed and I got fat and gave up racing.
Life changes also dramatically ramped up the stress level, and I came down with irritable bowel syndrome. The most pronounced IBS symptom I manifested was an abdominal pain that was identical to hunger pangs any time my stomach was not full. So I "self-medicated" by overeating, with predictable results.
Last winter, at age 56, I was diagnosed with hypogonadism and low T, and was put on TRT. I have no idea when this condition came on but I viewed going on TRT as my last best opportunity to get my weight under control and return to an athletic lifestyle, before old age sets in.
I tried to get serious about cycling again last year, before being diagnosed with low T, but my endurance was pathetic. I went at it like in the old days, riding hard as long as I could hold out, and adding mileage only when I had the speed to support it, with the intent of developing speed and letting the endurance take care of itself. All I could manage was about 60 minute rides, four to five days a week (fatigue-limited), and I struggled to make a 15 mph average. I did about 3000 miles total but weight loss was negligible, even though I kept the same diet, no adjustments whatsoever.
I don't know whether it was the exercise or the TRT but once I went on the testosterone, the IBS faded and went away. So did the compulsion to overeat. My diet was never especially unhealthy; little fried foods, red meat, or sugars, but always included pasta a couple of nights a week, a holdover from my days as a racer. My main problem before had been portion size, because either my belly felt full of I felt gnawing pains. But once the IBS faded, the portion size sort of reduced itself.
This year, I changed my approach, and deliberately have been holding back, with the goal of racking up as many miles as possible, with speed a secondary consideration. My cycling has been much improved, although I can't believe how hard it has been to improve even by a couple of tenths of a MPH, despite the weight loss. My endurance is closer to what I consider reasonable for a man my age, and by July I was able to ride "energetically" for as much as 3-hours. But I dialed back the average profile to two hours in the interest of being able to ride six days a week with a high effort level throughout. There was too little left in the tank the day after a three hour ride.
With seven weeks remaining in the year, I'm averaging ~200 miles a week. I already have logged more than 5000 miles, and I've lost 20+ pounds, both substantial improvements over last year. I have not adjusted my 'meal-time' diet, but I am drinking Cytomax (maltodextrin) when I ride (1 scoop), and I have a home-made post-ride glycogen recovery drink made from a cup of black coffee, a cup of chocolate milk and two heaping teaspoons of sugar.
The reason for the extra sugar drinks is I have tested each one individually, with and without, and my endurance was measurably better with. I tried riding on water-only, and my performance suffered after the first hour. And when I eliminated the coffee-choco milk mix, endurance suffered on the fifth and sixth rides of the week. Plus, the added calories aren't extravagant (<300/day), and I still was loosing weight. So I kept it up because I thought it was better supporting my goal of high mileage.
All that to get to this. For the past few years, my hemoglobin A1C has been in the pre-diabetic range. And I have family history of diabetes on my mother's side (but it hasn't manifested in either of my two older siblings). Despite that, I felt my weight was what was responsible for the high A1C, and believed that getting rid of the excess baggage would put it right. The problem was, I was having little success shedding the weight.
I thought that theory was born out this past spring, when my A1C was down to 5.4. At the time I'd been riding and on TRT for about two months, and I had lost a handful of pounds, mostly belly fat, so I attributed the drop in A1C to the two months or so of "juiced" cycling.
I still was shaking off the winter cobwebs then, and only riding about 60 minutes, six days a week. Back when I was racing, the theory was that a rider would exhaust his muscles' glycogen stores in 90 minutes of hard work, so if you were riding more than that, you needed also to be fueling during the ride. So a month or so after the spring blood tests, I had stepped up the length of my rides to two hours and I went back to using the Cytomax in my water as I rode. And I added the recovery drink after that.
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Last week I had blood work done again. Despite having lost more than another 15 pounds since the last test, my hemoglobin A1C has gone up, from 5.4 to 6.0. My diet hasn't changed, except I have added the sugary drinks to support my riding.
The Cytomax is 90 calories and 22g of carbs per scoop. The homemade recovery drink is about 200 calories, total, sugar & choco milk combined, and 2.5g of fat. But I'm burning >290 calories every half hour as I ride.
So my key question is, might the sugars I deliberately am adding to my diet in the interest of cycling performance be what is responsible for what would seem to be a fairly substantial rise in my hemoglobin A1C? And if so, in the grander scheme of things, is this something I should be worried about, particularly since I am continuing to loose weight? In other words, is this something that is offset by the long periods of aerobic activity I am involved in? Should I eliminate all unnecessary sugars, knowing my cycling endurance will suffer, or should I consider an A1C of 6.0 a reasonable price to pay for the increased performance and weight loss?
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Originally Posted by kelkel
