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Unexplained Decline in Lung Capacity and VO2Max?
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Unexplained Decline in Lung Capacity and VO2Max?


I am a 39 y.o. male law enforcement officer and recreational combat athlete (kickboxing, grappling, etc.).  I exercise consistently 4-7 days per week and employ a wide variety of conditioning methods, ranging from high intensity sprints to long, slow distance running and various resistance training protocols.  My concern is that despite my workout regimen, I continue to suffer from what I feel is unreasonable shortness of breath (esp given my activity levels) and seem to be losing lung capacity (~18% as measured via PFT over the last 15 years) and my VO2Max is declining (based on two different VO2Max test over the last couple of years - one was upper 30's and newest was lower 30's using ml/min/kg of bodyweight).  I have seen and been extensively tested by both a cardiologist and pulmonologist, both of whom say I am in good/great shape.  I take asthma medication (singulair, advair, albuterol) although no tests have conclusively proven I have asthma.  Below is some testing history in the event it may help:
- have had all available tests, except an angiogram
- only finding has been ocassional PVC's, left axis deviation, and incomplete bundle branch block, all of which cardiologist said not to worry about and should not be causing problems
- resting heart rate has increased over the years, but I suspect this may be due to initiation of thryoid medication
- slightly elevated LDL and triglyerides and slightly low DHL cholesterol
- PFT's all "normal" but show decrease in total lung capacity of ~18% over last 15 years (something I noted, told this was normal by most recent pulmonologist)
- PFT with albuterol showed no significant increase in function.
- Passed methacholine challenge test, although I did sense some constriction
- history of airborne allergies, chronic sinusitis
- multiple chest x-rays, all of which were described as normal with the exception of one several years in which some small aveole (sp?) inflammation was noted, none noted since then
- hypothyroid, determined in 2007
- suspicion for hypopituitarism in 2008 (low testosterone, low LH/FSH, low IGF-1, failed HGH stimulation test), but no pituitary tumor identified
- all other blood work essentially normal
- minor (barely noticeable) pectus excavatum
- osteoarthritis in neck and back
- lots of gas and bloating and frequent stools, possible GERD (have taken nexium and similar drugs in past, but not currently)
- ENDOCRINE: thyroid, testosterone/novarel (to stimulate natural testosterone production), arimidex (1/4 pill a week to combat aromatase of testosterone), HGH, metformin (to counteract blood sugar increase from other meds)
- ALLERGIES/"ASTHMA": singulair-PRN, allegra-PRN, astelin, nasarel,
- CHOLESTEROL: niaspan, omacor (fish oil)

Any guidance or suggested tests, etc., would be much appreciated!

Avatar m tn
P.S. - Some of the shortness of the breath is most prominent when walking up stairs after being fairly sendentary for a period.  If I am "warmed up" the shortness of breath is much less pronounced or non-existent.  In other words, my symptoms seem to improve with exercise, although I still have less exercise capacity than I think I should have given all of the exercise I do.  

Some suspicions I have researched include:
- glucose storage disease
- endothelial dysfunction/delayed vasodilation

Any other ideas would be much appreciated!
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