DEAR DR. DONOHUE: I am 18, athletic, healthy and confused about what happened to me. A few of my friends and I got into a competition of sit-ups and squats. We wanted to see who could do the most without taking a break. I won. I also lost. The next day my stomach and leg muscles were so sore I could hardly get out of bed. The day after that, my urine turned dark brown and I had to stay in bed. I said I had the flu. By the fourth day, I was feeling better and could move. What happened? It was the exercise, wasn’t it? – P.L.

ANSWER: I’d say so. I believe you had rhabdomyolysis (RAB-doe-my-OWL-uh-siss). The nonstop exercise caused death of many muscle cells that released their contents into the blood. The change in urine color was evidence that the cells released myoglobin, a material inside the cells that transports oxygen. Muscle soreness is expected with death of muscle cells.

This condition is dangerous. The kidneys can shut down when they’re confronted with having to deal with all those inner products of muscle cells.

I don’t want to sound overly dramatic, but this rhabdomyolysis is an emergency. Most of the time, it has to be treated in the hospital with intravenous fluids and with a close watch on kidney function. Not only do muscle cells release their inner structures, they release large amounts of potassium. High blood potassium weakens the heart and can lead to the production of dangerous heart rhythms.

Rhabdomyolysis occurs in conditions other than exercise. It happens, for example, when there are crushing muscle injuries.

I’m sure you’ve learned a lesson and won’t participate in another exercise contest like this.

DEAR DR. DONOHUE: A doctor prescribed testosterone for me and told me to start a program of weightlifting to build bone mass. I have lost 23 percent of my bone mass and three-quarters of an inch in height.

After three months, another blood test revealed a testosterone level 20 times normal. So, instead of applying the testosterone gel each day, I was told to apply it once a week.

Does weightlifting by itself increase the testosterone level? If so, perhaps there is no need for me to use the gel. I am 84 years old. – S.R.

ANSWER: If weightlifting increases testosterone production, it can’t increase it all that much, or so many bodybuilders would not turn to synthetic testosterone (steroids) to assist them in building muscle bulk. Any increase from weightlifting alone could not compare with the amount of testosterone provided from prescription replacement therapy.

A weightlifting program can restore bone strength and prevent further loss of height.

Testosterone production begins to wane in men at about age 40, and slowly drifts downward for the rest of life. At 70, most men make only 70 percent of the testosterone they made in peak production years.

There is a legitimate role for prescribed testosterone. Male osteoporosis is one of those roles. You have osteoporosis. You have lost height. Your backbones are shrinking due to it. Testosterone adds to your exercise program.

Men who have demonstrated low blood levels of the hormone on repeat testing and who show signs of deficiency benefit from replacement therapy.

Don’t throw out your gel unless your doctor says it is acceptable for you to do so.

DEAR DR. DONOHUE: I would like your opinion on which is better – a rowing machine or a stationary bike. I made a New Year’s resolution to get in shape, and I’m just getting around to fulfilling it. I can get either one of these machines free. Which do you thing I’d benefit more from? – K.O.

ANSWER: They’re both excellent equipment for improving your heart function and for losing some weight.

You better try them before you make a choice. A rowing machine requires exhausting exercise. You’ll know you’re up to it only if you try it out. If you can manage sustained rowing, then the choice is a matter of your personal preference.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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