Symptoms

Slow recovery from training.

Recovery is hormonal. If you're doing the same training volume you've done for years and it's no longer landing, the upstream issue is usually anabolic hormone decline (T, IGF-1) or recovery infrastructure (sleep architecture, nutrient adequacy). All measurable.

Most common causes

Low growth hormone / IGF-1

GH pulses during slow-wave sleep build the recovery infrastructure. Low IGF-1 (especially under 150 ng/mL in adults) flattens recovery.

Test for itIGF-1, fasting glucose, A1c, sleep assessment

Low testosterone

T is the primary anabolic hormone. Low T reduces protein synthesis rate and muscle repair capacity. Often the cause if strength is dropping.

Test for itTotal T, free T, SHBG, estradiol

Suppressed sleep architecture

Slow-wave sleep (deep sleep) is where most physical recovery happens. Reduced SWS, from cortisol, alcohol, age, or poor sleep, directly impairs recovery.

Test for itSleep tracker data, AM cortisol, alcohol intake

Nutrient deficiency (iron, B12, vitamin D)

Subclinical deficiencies in any of these reduce energy delivery and recovery capacity.

Test for itFerritin, B12, MMA, 25-OH vitamin D, RBC magnesium

Overreaching / underrecovery

Sometimes it's just training too much and recovering too little. A real assessment, not just a hormonal one.

Test for itHonest training log + sleep + nutrition review

What works at OPTML

Sermorelin

If IGF-1 is suboptimal, GHRH-driven restoration directly improves slow-wave sleep and recovery hormone output.

See full details →

TRT (men, if confirmed low)

Restoring T to optimal range restores recovery capacity and protein synthesis.

See full details →

NAD+

If you've ruled out the above, NAD+ subq supports cellular energy and mitochondrial recovery, particularly noticeable in active adults 40+.

See full details →
“Just train less” is sometimes the answer, but if you've done the same volume for years and it suddenly doesn't recover, that's a hormonal signal, not an overtraining problem.
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GH Optimization Score →
Slow recovery is a classic low-GH pattern. Take the 2-minute composite score to see whether your growth-hormone axis is the bottleneck.

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