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How do you know if you are a healthy athlete?   


We keep being told ‘healthy people are dying’.  But were they healthy?   Are you healthy?  We think because we run marathons or compete in triathlons that we are healthy, people are always saying ‘oh you are so fit’.   However, there is a big difference between cardiovascular fitness and metabolic fitness.  

Exercise is a stressor on the body – not just a physical one.  You may be over-training along with an inadequate diet creating micro-nutrients deficiencies and oxidative stress compounded with poor sleep creating both physical and physiological stressors.  Worrying about missing a training session creates a psychological stressor.  These all build up to create a total ‘stress load’ in the body and over time this can have significant negative impacts on our health.   

Endurance athletes often have an ‘A type’ personality so they push themselves in all aspects of their lives.  This is often un-sustainable as we age.  The best way to keep doing what you love is to be preventive.  Don’t wait until your body is broken and you can’t put off the inevitable.

So where to start?  Simple – test.   Test don’t guess.   You wouldn’t leave the power output on your latest turbo session to guess work or are perhaps a little addicted to improving your 5k/10k time and keep a close eye on pace when you run, so why guess what is going on with the engine that drives those outputs?   

As an endurance athlete myself I will not easily recommend that my clients stop training as I understand that eliminating something you love is not always the best plan but we need to understand what we are dealing with.  A plan can then be put in place to address the imbalances we see.  Depending what is uncovered, in context of your symptoms and history, it may involve reduced slightly reduced training for a little while while we support your body back to optimal health, it may involve removing fasted training sessions and it will certainly involve learning to listen to your body and putting some basic conditions in place such as prioritising sleep and assessing your diet.   This is likely to not only improve your performance but your chances of withstanding well a second wave of Covid!  


Blood testing 

Here are some blood markers that you should consider testing as a starting point:   

  • Total white blood cell count plus WBC differential.  
  • A red blood cell (hematology) panel.  
  • Fasting insulin and glucose markers. 
  • Vitamin D and serum folate status. 
  • FULL iron panel (not just ferritin or serum iron). 
  • Thyroid function – TSH, total T4 and T3 and free T4 and T3.  
  • Liver markers such as AST, ALT, GGT and ALP.  
  • Protein markers such as albumin and globulin.  
  • ACTIVE B12 and serum B12.  What is in the serum in the blood is NOT the same as what is in the cell.  
  • Red Blood Cell Magnesium. 
  • Electrolyte makers such as sodium, potassium and chloride. 
  • Cholesterol panel including fasted triglycerides. 
  • Additional useful markers are IGF-1, homocysteine, creatinine and creatine kinase.

Please note that the following markers do NOT tell you what you probably think they do which are commonly found on certain, cheaper blood test panels on the markers that are aimed at athletes: 

  • a one-off serum cortisol.  Being told ‘your cortisol levels are fine’ based on this information is wrong and misleading.  Cortisol is a circadian hormone that should go up and down during the day and a one-off test gives you minimal information.   To understand more about your cortisol levels and hormone status a urine based test called the DUTCH test is the best and easily organised.
  • Looking at TSH alone and being told ‘your thyroid is fine’.  TSH is the hormone that stimulates the thyroid to produce T4 which must then be converted to T3, the active thyroid hormone.  You need to see all of these markers to understand what is happening with your thyroid function.  
  • Looking at ferritin or serum iron alone and making an assumption on your iron status.  Iron metabolism is complex and involves not only iron but, for example, copper and magnesium.   

Adopting a functional approach in sport nutrition is important.  Assessing the underlying basics of your body and overall health and then adding in the building blocks of supplementation and ergogenic aids will allow you to optimise not only your performance but longevity of health and enjoyment of life.

If you want to find out more how you can run these tests and interpret the results  please contact Katherine here.