Elevation of plasma estradiol in healthy men during a mountaineering expedition

The following study was undertaken to study the effects of multiple stressors on the pituitary-testicular axis in men. We examined the endocrine responses of 16 healthy young men participating in a mountain training exercise. Blood was drawn at 1830 m just before ascent (t = 0 h), after an overnight rest at 3050 m (t = 24 h), and immediately after a descent from 3050 m in adverse conditions (t = 48 h). Plasma E2 increased significantly through the study periods (medians: 74, 104, 164 pmol/l at t = 0, 24, 48 h) while 17 alpha-hydroxyprogesterone progressively decreased. Testosterone and the bioactive LH to immunoreactive LH ratio decreased only at 48 h. There were no changes observed for plasma cortisol, prolactin or thyroxine. The observed rise in E2 may be due to one or more stressors associated with altitude, including hypoxia and increased solar radiation. This data suggests a role for E2 in the secondary testosterone decrease.     

Evaluation of sympathoadrenal activity, adrenocortical function and androgenic status in five men during a Himalayan mountaineering expedition (ascent of Mt Pabil, 7,102 m, 23,294 ft)

Sympathoadrenal activity, adrenocortical function and androgenic status were studied in five well-trained mountaineers during the different phases of a mountaineering expedition during the ascent of Mt Pabil (7,102 m) in the Ganesh Himal massif. Sympathoadrenal activity was evaluated by measuring urinary excretion of adrenaline, noradrenaline, metanephrines, and vanillinmandelic acid. Adrenocortical function was assessed by measuring urinary excretion of free cortisol, 17 OHCS (17-hydroxycorticosteroids) and androgenic status by measuring testosterone glucuronide, Adiol (5 alpha-androstane-3 alpha, 17 beta diol) and 17KS (17-ketosteroids). Reference values were obtained at Chamonix at 1,037 m during rest. During trekking noradrenaline increased significantly while Adiol and 17-KS decreased. The fall in the urinary androgenic pool persisted during the next phases of the expedition. At base camp (4,800 m) noradrenaline, its metabolites and free cortisol increased mainly during physical activity. Above 6,000 m, adrenaline, noradrenaline, their metabolites, free cortisol and 17-OHCS reached a maximum value. During the return to sea level, the urinary level of these parameters was still high. The drop in the urinary androgenic pool observed during trekking and exposure to high altitude confirms results obtained in other studies on prolonged efforts. This hypoandrogenicity may play an important role in the metabolic adaptations as well as in the mental state of the climbers. The increase of sympathoadrenal activity and of adrenocortical function may be considered as a regulatory element in the adaptative response to hypoxia and other stressors proper to high altitude.     

Cardio-respiratory adaptation to physical exercise and hypoxia after a high-altitude expedition.

Seven young, male subjects were tested before and immediately after 6 weeks high-mountain expedition. Cardio-respiratory measurements were performed at rest and during standard physical excercise (10 min, 100 W) when breathing atmospheric air or hypoxic mixture (14% O2 in N2). After the expedition an increased V o2 max (16% an average) and diminished heart rate response to submaximal exercise were found. This was observed during air and hypoxic mixture breathing. There was significant increase in stroke volume and cardiac output during the exercise. No significant differences in ventilatory parameters were found nor at rest or during exercise under condition of breathing atmospheric air or hypoxic mixture. No changes in erythrocyte count or haemoglobin concentration in the blood were found. The physiological changes which developed during high-mountain expedition were more dependent on physical that hypoxic training.     

Candide Becomes a Doctor

It has been shown that things cannot be otherwise; since everything was created for a purpose, this purpose must inevitably be the best possible. Observe that noses were made to wear spectacles and so we have spectacles. Legs were obviously intended to wear breeches and so we have breeches. Stones were made to be cut and to be made into mansions. That is why His Lordship has such a very fine mansion. The greatest baron in the province should be the best housed. Pigs were made to be eaten, so we eat pork all the year round. Therefore, people who told us merely that everything was well ordained were talking nonsense. They should have said, “Everything is ordained for the best.”¹