哇！好厉害！美女可以squat 自己的体重了！！ 太好了！！！ 加油加油！！！

我会经常来的！！

美女好！！！ 首先医生说的normal range 我要吐槽一下。。。 血检的normal range 的范围那么大！！！ 想想美国的population 40% 都是obese, being in the normal range doesn''t make it optimal at all, especially on the far end of the range. 而且很多医生都是开药针对symptom，不针对root cause。A lot of my clients are told that their blood work is normal but the doctors don''t really test much besides the basic CBC, CMP, and lipid, which are not the full picture of your health.

吐槽完毕。 关于DEXA scan 我觉得可以做， 但是 comprehensive blood work 会更好（特别是测 estrogen, testosterone, progesterone, thyroid, etc. )。 当你知道自己的荷尔蒙的marker 在哪里，你可以调整饮食，休息，训练，supplement 等去改善。 DEXA 的话，我做过20 多次，哈哈哈，我过去几年比健美赛，刷脂很多次，所以经常去测试，看自己减了多少。 DXA 的data 也不是超级准确， DXA sees anything that''s not fat as lean mass. Which means if you drink a lot of water, DXA can see the hydration as lean mass. Also if you workout the day before, you might see muscle gain in that area due to inflammation.. The most accurate way to do DXA is to take a complete rest day, and do DEXA scan completely fasted without food or water first thing in the morning, and do that every time to get an accurate measurement of true muscle gain.

不好意思我啰嗦了，我因为锻炼了10年，饮食也比较注意，所以我不会定期检查骨密度肌肉量之类的， 去年做的DXA 我的骨密度ok。我觉得美女经常锻炼的话，不需要太担心这个。 但是我会定期做comperhensive blood work。

我们LA 这里有DXA /DEXA 的scan， 40 多块钱一次，所以我以前经常去做。。不需要经过医生。。 我不知道美女的医生是否有测comprehensive blood work，大部分的医生都不会测。 很多时候需要自己掏腰包另外测，不过也只是差不多200 美金，查40-50 多个markers。

太谢谢教练的详细解释了！我不怕自己花钱做comprehensive blood work. 我非常愿意自己花钱做这个，但是我需要专业人士帮我分析结果，告诉我下一步怎么做，是改善饮食，调整训练内容，还是补充激素supplement, 上荷尔蒙疗法。这个是家庭医生还是personal trainer, 还是要两者之间沟通？我现在的家庭医生感觉就是你血压血糖正常没有糖尿病就行，匆匆打发。我想要的是帮助我在更年期快来之前根据我的肌肉量激素荷尔蒙数据量体裁衣做优化。我要的不仅仅是四十岁健康，我要的是80岁仍然保持行动自如每天不难受有生活质量。这个目标要求我现在就的开始。但是怎么找这样的医生呢？ personal trainer 能帮我推荐医生然后建立这个合作关系吗？

LZ你好。我健身多年，四月份参加了人生中第一次健美比赛，成绩不错，会继续比下去。

我看到你对一个问题的回复里提到你也参加健美比赛，我只是好奇你在非赛季和赛季体重差别有多大？我在增肌期增加了二十多磅，焦虑到数次做梦早晨赶时间但是满衣柜衣服找不到一件能穿上的。减脂期（备赛期）虽然每天饥肠辘辘的但是精神上是愉快的。

我明白增肌期体重的增长和体型的变化是增长肌肉的必然结果，没有增肌期也不会有减脂后漂亮的肌肉线条。但是想到以后的比赛（计划一年一次吧），我一年中大部分时间都是增肌期都是很肥壮，我就觉得很恐惧。

我想和你交流一下，你在增肌期有这种焦虑吗？有什么可以做的来应对吗？有人建议说准备好大一点的衣服，这样你就不会因为衣服绑在身上而焦虑。我已经为了这一轮增肌屯没有线条宽松的衣服了。

美女好！ 我的建议是有大一点的衣服，这样可以适合你的size differences。 我啰嗦一下关于赛后体重的事情。

因为你比赛的时候超级lean，所以现在增加了20 多磅让你很焦虑，这个是可以理解的。。虽然你可能在其他人眼里很fit，但是你会觉得你很肥壮。

关于需要增多少，具体要看你，有两个比较conflicting 的事情需要考虑。

一般来说，如果是不想比赛的时候刷脂太辛苦，那么建议off seaon 不要超过10-15 磅 stage weight。（but your new stage weight will be higher）。体脂太高，刷脂的时候也会掉一点肌肉。

On the other hand, I am not sure if the coach that you worked with inform you about how contest prep will affect you hormonally. (Most coaches are not educated on this topic unless they take special functional health courses or have master's degree). When you are on contest prep, your hormones (estrogen, progesterone, testosterone, thyroid, etc.) will be greatly impacted. it is very common to see female competitors with lab work that looks like they are in postmenopause. In order to reverse this, your body fat has to come back and you have to eat more calories.. Everybody is different so you don't know how much you will need to be back to normal. And when your hormones are back to optimal places, your muscle growth will also be more optimal.

That's why it is double edge sward about how lean you should stay during the off-season. It is best to get blood test done routinely (every 3 to 6 months) so you know if you are healthy enough. A lot of girls stay lean during off season, and if they are not on hormone replacement therapy (HRT), they tend to run into hormone and gut problem down the line (everyone is different, but a lot of women stay lean long term can have hormonal issues).

不好意思说多了。。。 因为网上关于off season 需要多lean debate 很多。。 这个比较tricky。

美女好！希望你不介意我啰嗦。。

 首先， personal trainers don''t know much about nutrition, let alone hormones. I know this might be surprising to hear, but personal trainers are more educated in training/workout, not nutrition. For hormones, unless they take special courses, or they have master''s degree, they can''t really help you. I work with a lot of women over 40 and I noticed a lot of them struggle with weight loss. I took different functional health courses so I know a lot more about functional health than your average personal trainer, and I help my clients to read their labs and give them suggestions. 

Here is what you can do, you can go to a wellness clinic or hormone replacement clinic, a lot of them offer comprehensive blood work. (you can also get it done and bring it to them), they usually have practitioners to read the labs and give you suggestions. One thing I don''t like about them is, they are more motivated to recommend you to get on whatever supplements or hormones through their clinic, so they can make money from you.. (but you don''t have to buy any..).. 

I usually recommend my clients to get blood test here 

https://www.practitionerdepot.com/lab/product/female-fat-loss-panel?variant=NO%20REVIEW

You can use my code MAY, you might save 5%. Lol. The cost for this fat loss panel is $190. When you order, you can choose “with review”, they charge you $75 to go over the labs with you. They also have other labs too. When you place the order, they will send you a doctor’s form, you will bring it and go to labcorp to get blood drawn.  过一二周你就会有结果。你可以弄一个lab corp 账户，输入你的名字还有SSN，那么result 就会自动链到你的账户，你可以下载。

I hope this is helpful! 不好意思又啰嗦了。

谢谢LZ和层主！

这真是困扰我很多年的问题了。每次锻炼或者跳舞之后，很累，却完全睡不着，更容易失眠。

原来是镁的问题。

谢谢你的回复。

关于荷尔蒙，我一直在接受HRT，这个和我为了比赛而刷脂无关。我几年前就查出睾酮几乎降到了零，从那时开始我就开始了HRT。

效果还是不错的。但是有一个负面的结果就是我没法参加OCB比赛了，他们连HRT都禁。

啊，教练我爱你！谢谢你帮我解释了一个我一直不知道该到哪里去问的问题。我这就去约您推荐的检查。非常感谢您详细的解释！