Physical Health Diagnoses in Athletes
Time to read 12 min
Time to read 12 min
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| As sports is become more popular and lucrative many people are taking it up professionally. Nutrition for an athlete depends upon the type of sport and also intensity and duration of exercise. Questions about weight management, disordered eating patterns and supplementation are common. Getting the right blood tests helps health care practitioners to determine the course of action with their clients. With the right intervention, we can reduce fatigue and recovery, increase muscle mass, power and stamina amongst others. Since athletes push their bodies to the limits, blood tests can also be used as a tool to prevent deficiencies and injuries. Blood tests also help you to monitor the progress of your athletes health. | |||||||||||||
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| DEFICIENCY TESTING | |||||||||||||
| Blood test | What it is | Why is it tested ? | What it means | Nutritional intervention | |||||||||
| Iron | Mineral | Iron is an essential mineral found in every cell of the body. Its main role is to transport oxygen in the blood to the tissues. Iron ensures that our muscles are working properly. It also helps the body convert carbohydrates into energy during exercise. | Low iron levels indicate anemia. | • Iron rich foods must be coupled with Vitamin C rich foods. Vitamin C helps to absorb iron, however it is heat sensitive. • Focus on increasing consumption of heme iron as absorption of iron is quicker than with non heme iron. • Anaemia is also associated with Vitamin A deficiency. |
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| Calcium | Mineral | Calcium is especially i m p o r t a n t for athletes because they are more likely to lose calcium, as well as other minerals, through perspiration. In addition to being important for strong bones, calcium is required for muscle contraction. Without enough calcium athletes may experience muscle cramps. | A blood calcium test is ordered to screen for, diagnose, and monitor a range of conditions relating to the bones, heart, nerves, kidneys, and teeth. | • Vitamin D deficiency increases risk of calcium deficiency • Hypercalcemia is a condition in which the calcium l e v e l i n y o u r b l o o d i s a b o v e normal. Too much calcium in your blood can weaken your bones, create kidney stones, and interfere with how your heart and brain work. • Hypercalcemia is usually a result of overactive parathyroid glands. |
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| Blood test | What it is | Why is it tested ? | What it means | Nutritional intervention |
| Phosphorus | Mineral | To evaluate the level of phosphorus in your blood and to aid in the diagnosis of conditions known to cause abnormally high or low levels of phosphorus. | Abnormal calcium levels can be attributed to high or low Phosphorous levels. Kidney disorders or uncontrolled diabetes can lead to irregular phosphorus levels. Athletes taking calcium or phosphate supplements can also have erratic. |
• Calcium Phosphorus ratio is important. Calcium to Phophorous ratio should be 1.5: 1 |
| Magnesium | Mineral | Magnesium is required for muscle contraction, energy use, nerve function, protein production, enzyme function and bone strength, but is not made by the body itself. | When you have symptoms such as weakness, irritability, cardiac arrhythmia, nausea, and/or diarrhea that may be due to too much or too little magnesium; when you have abnormal calcium or potassium levels. | Since a low magnesium blood level can, over time, cause persistently low calcium and potassium levels, it may be checked to help diagnose problems with calcium, potassium, phosphorus, and/or parathyroid hormone – another component of calcium regulation. |
| Zinc | Mineral | Loading up on carbs while limiting protein and fat causes deficient levels of zinc in up to 90 percent of athletes. This can reduce energy and endurance. | Deficiency of zinc intake decreases oxygen uptake — leading to fatigue. Helps metabolising carbohydrates. Adequate zinc is needed to maintain good sense of smell and taste. Zinc also plays an important role in wound healing. Zinc also is needed to make proteins. | • Diarrhoea is a common feature of zinc deficiency. • Low protein and fat intake may lead to suboptimal levels of Zinc. Vegetarians are at higher risk of zinc deficiency. |
| Vitamin B | Vitamin | B vitamins are micronutrient for metabolism, energy production, and for cell, skin, bone, muscle, organ, and nervous system health. | Deficiency may lead to reduced energy for high intensity exercise. Loss of appetite could indicate Vitamin B deficiency. |
• Effective oral dose is between 647-1032 mcg daily. |
| Folate | Vitamin | Folate deficiency can hinder cellular and tissue development and can affect several aspects of performance, like decreased energy. | Testing may also be performed for those who experience low energy levels, alcoholism or with chronic diseases associated with malabsorption, such as Celiac disease. | • Underconsuming folic acid can actually hinder athletic performance by reducing the amount of red blood cells available to deliver oxygen to your muscles. Chronic low folate intake can lead to fatigue and anemia. |
| Vitamin C | Vitamin | Vitamin C is also important to athletes because, as an antioxidant, it may help to reverse some of the oxidative damage that may occur from exercise. Vitamin C promotes a healthy immune system and may help to prevent the dip in immune function that may occur right after exercise. | Low Vitamin C levels decreases recovery time. | • Vitamin C is water soluble and is not stored in the body. So Vitamin C rich foods must be consumed regularly. • Vitamin C is heat labile. |
| Omega 3 | Fatty acid | Omega-3 fats have also been shown to augment blood flow to muscles during exercise, decrease muscle soreness by 35%, reduce swelling, and increase range of motion after damaging exercise.Omega-3s in combination with exercise was shown to maximize fat loss. | Research supports that omega-3 supplementation improves the anabolic effect of training and counteracts muscle loss. Additionally, fish oil can help counteract the effects of delayed onset muscle soreness (DOMS) | Lots of athletes take Omega 3 suppliments. Side effects of omega-3 supplements are usually mild. They include unpleasant taste, bad breath, bad-smelling sweat, headache, and gastrointestinal symptoms such as heartburn, nausea, and diarrhea. |
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| Blood test | What it is | Why is it tested ? | What it means | Nutritional intervention | ||||
| HbA1C | Glycated hemoglobin | To determine the efficacy of insulin. There is significant association between intensity of the training regimen and both FPG and HbA1c. Elite athletes showed a consistent trend towards higher HbA1c values. |
HbA1c is likely to be affected by iron deficiency and iron deficiency anaemia with a spurious increase in HbA1c values. | |||||
| Testosterone | Male sex hormone | The main anabolic steroid hormone produced by your body is testosterone. Anabolism effects promote muscle building. | Moderate endurance training is perfect for boosting your body's production of testosterone. Also, short, intense interval workouts have been found to significantly increase testosterone levels. However, the opposite effect can occur in runners who are training for an ultramarathon and running extremely long distances. | • Moderate endurance training is perfect for boosting your body's production of testosterone. Also, short, intense interval workouts have been found to significantly increase testosterone levels. However, the opposite effect can occur in runners who are training for an ultramarathon and running extremely long distances. • If testosterone levels are low in men, check for stress levels ( adequate cortisol levels, ESR, CRP) - an anti inflammatory diet will help. • Ensure healthy Vitamin D levels for adequate testosterone production. • Bromelain supplementation was associated with maintaining testosterone concentration. • The values of testosterone for men and women are different. High testosterone in women can lead to PCOS. |
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| Blood test | What it is | Why is it tested ? | What it means | Nutritional intervention |
| Oestrogen | Female sex hormone | Oestrogen is responsible for regularising periods. Low oestrogen causes mood swings and depression. On the other hand Oestrogen dominance causes thyroid issues and PCOS. |
• Oestrogen may reduce disordered eating in female athletes with irregular periods. | • As women age, there is a natural decline in testosterone and progesterone levels, leaving a relative excess of estrogen. • Regular intense exercise reduces oestrogen levels. • To reduce oestrogen dominance - reduce xenoestrogens, oestrogen promoting foods such as - flax seeds , sesame seeds, soya, olives, fibre rich food. Polyohenols help to reduce oestrogen levlels- whole grains are the best examples. |
| Cortisol | Stress hormone’ | Cortisol regulates a wide range of processes throughout the body, including metabolism, stress and the immune response. | • High cortisol levels increases weight gain. • High cortisol levels also increase bruising, increases recovery time and muscle weakness. |
• Caffeine increases cortisol secretion in people undergoing mental stress. • DHEA, also an adrenal hormone, counters the action of cortisol in many tissues • ACE Vitamins helps reduce inflammation caused by high cortisol levels. |
| Progesterone | Progesterone is a hormone released by the ovaries. | • Changing progesterone levels can contribute to abnormal menstrual periods and menopausal symptoms. • Low progesterone levels increases weight gain & thyroid dysfunction. |
• The six highest progesterone binding herbs and spices commonly consumed were oregano, verbena, tumeric, thyme, red clover and damiana. Consumption of these helps to increase progesterone. • Zinc increases follicle stimulating hormone (FSH), which supports a healthy ovulation, which triggers the ovaries to produce progesterone. • B6 is involved in estrogen metabolism and can easily become depleted if estrogen dominance is a problem. B6 has shown to decrease oestrogen while increasing progesterone levels. |
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| DHEA | Dehydroepia ndrosterone | DHEA helps to make male and female sex hormones within the body. | DHEA supplements are sometimes used by athletes because of a claim that it can improve muscle strength and enhance athletic performance. That's because DHEA is a ‘prohormone' -- a substance that can increase the level of steroid hormones such as testosterone. | • DHEA is a steroid and it is banned substance and athletes cannot take it as a suppliment. • DHEA is made using cholesterol. Ensure adequate fat in the diet. • Elevated insulin causes a decreased production of DHEA in the adrenals. • An anti-inflammatory diet is a critical part to de- stressing the body and boosting DHEA levels. |
| SHBG | Sex hormone binding globulin | It is a protein that is produced by the liver and binds tightly to the hormones testosterone, dihydrotestosterone, and estradiol. | • Excessively high SHBG in male athletes decreases the amount of free testosterone. In female athletes it can c a u s e m e n s t r u a l irregularities. • Increased SHBG levels is seen in hyperthyroidism. |
• Include lots of cruciferous vegetables such as broccoli and cauliflower to help metabolize excess estrogen which further lowers SHBG. |
| IGF 1 | Insulin-like growth factor 1 (IGF-1), also called somatomedin C | IGF-1 is a hormone similar in molecular structure to insulin. It plays an important role in childhood growth and continues to have anabolic effects in adults. | • Healthy levels of IGF is known to reduce muscle wasting and increase muscle mass. • Decreases inflammation |
• Its a prohibited substance by WADA. • Excess body fat decreases IGF levels. • Reduce sugar intake. |
| Thyroid panel | Athletes who may benefit from this test include anyone with low energy, weight gain, chronic digestive problems or joint pain, brain fog, skin or hair issues, hormonal issues, and depression. | • Please refer to the section on thyroid diseases. |
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| Blood test | What it is | Why is it tested ? | What it means | Nutritional intervention | ||||
| Hemoglobin | It is a protein in red blood cells that c a r r i e s o x y g e n thr oughout the body. | Low hemoglobin count may indicate that the person is suffering from anemia. | Low haemoglobin levels result in • Weakness / tiredness • Dizziness • Shortness of breath • Irregular heartbeat |
• The protein haemoglobin is made out of iron- so it is important to take iron rich foods. • Vitamin C helps the body absorb iron from non heme iron at a better rate, while vitamin C also plays an important role in synthesizing red blood cells. • Ensure adequate Vitamin B12 levels; if not megaloblastic anemia / pernicious anemia may ensue. |
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| Iron | Mineral | To check for iron deficiency anemia. | Low iron levels result in • Weakness / tiredness • Dizziness • Shortness of breath • Irregular heartbeat |
• Consume iron rich foods, especially non heme iron rich foods.Heme iron is typically absorbed at a higher rate than non-heme iron, which means that the body more easily absorbs iron from animal products than iron derived from plant foods. • Vitamin C helps the body absorb iron from non heme iron at a better rate, while vitamin C also plays an important role in synthesizing red blood cells. |
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| Transferrin saturation | Indirect test for iron levels | Transferrin saturation, is the value of serum iron divided by the total iron-binding capacity. A value of 15% means that 15% of iron- binding sites of transferrin are being occupied by iron. | Low transferrin indicates iron deficiency. | |||||
| Ferritin | Ferritin is a protein which contains iron. | Low ferritin levels indicates your body's iron stores are low and you have iron deficiency. | • Low levels of ferritin means you have too few red blood cells. Ensure adequate protein intake - both in terms of protein quantity and quality. • Consume a diet rich in iron, Vitamin C and Vitamin B. |
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| Blood test | What it is | Why is it tested ? | What it means | Nutritional intervention | ||
| Hematocrit | The ratio of | Trained athletes, particularly in | ||||
| the volume of | endurance sports, have a | |||||
| red blood | decreased hematocrit, which is | |||||
| cells to the | sometimes called “sports | |||||
| total volume | anemia.” This is not anemia in a | |||||
| of blood. | clinical sense, because athletes | |||||
| have in fact an increased total | ||||||
| mass of red blood cells and | ||||||
| hemoglobin in circulation | ||||||
| relative to sedentary | ||||||
| individuals. | ||||||
| INFLAMMATION | ||||||
| Inflammation is the body’s natural defencenutrigenomics mechanism. It is part of the body’s innate immune system and can be triggered by many things. It is a complex process by which the body’s white blood cells are released into the blood or affected tissues to fight infection. Inflammation is essentially the body’s way of tagging a part of the body to receive attention from the immune system. | ||||||
| There are two types of inflammation, acute and chronic. Acute inflammation starts quickly and generally disappears within a few days. Acute inflammation protects us against damaged cells, viruses, and bacteria. In this way, inflammation is beneficial.Chronic inflammation is systemic inflammation that can last for months or years. Many things can contribute to chronic inflammation including inflammatory foods, environmental toxins, excess weight, and stress. | ||||||
| Blood test | What it is | Why is it tested ? | What it means | Nutritional intervention |
| CRP /hsCRP | C-reactive protein/ high sensitivity CRP | To identify the presence of inflammation and to monitor response to exercise and training. | • Athletes should be particularly concerned with monitoring their levels of CRP since performance is so closely tied to their cardiovascular fitness. • Inflammation has a negative effect on wound healing, recovery from strenuous exercise and immunity. |
• Avoid processed & sugary food. • Anti inflammatory diet - Vitamin C & E rich food. • Consume raw fruits and vegetables. • Drink adequate amounts of water. • Specific foods that have been shown to have an effect on lowering inflammation include garlic, grapes, herbs and spices, soy protein, nuts, olive oil, black and green teas, and vinegar. • Maintain healthy blood glucose levels. • Smoking increases CRP levels. |
| ESR | Erythrocyte sedimentation rate. | To identify the presence of inflammation and to monitor response to exercise and training. | Short term fatigue in elite athletes can be attributes to high ESR levels. | Moderately elevated ESR occurs with inflammation but also with anemia, infection, pregnancy, and with aging. A very high ESR usually has an obvious cause, such as a severe infection, marked by an increase in globulins, polymyalgia rheumatica or temporal arteritis. Diet should be based on the root cause of high ESR levels. |
| RBCW | Red blood cell width | RBCW is an expression of the variation in size of the red blood cells that make up the total population of red blood cells in an individual. The size of the blood vessel has a lot to do with the maturation of the blood cells and this is dependent upon methylating agents such folate and B12. | Red Cell Distribution Width (RDW) is an excellent test to detect inflammation and oxidative stress. It is a robust predictor of the risk of mortality from all causes and bloodstream inflection. | • Ensure adequate folate and Vitamin B12 levels. • Anti inflammatory diet |
| Cortisol | Hormone which regulates metabolism, immune response, control sugar level etc | High cortisol levels can lead to symptoms such as weight gain, hypertension, high blood sugar, osteoporosis and fragile skin while low levels may cause weight loss, weakening of muscles, fatigue, low blood pressure, vomiting and diarrhea and loss of consciousness. | To reduce Cortisol levels: • Anti inflammatory diet: whole grains, no processed, nuts , fish, turmeric, ginger, cinnamon • DHEA promoting foods: wild yams, soya, flax seeds, salmon, olive oil • Vitamin B complex • Adaptogen |
* Medical Disclaimer - The following information is for educational purposes only. No information provided on this website, including text, graphic, and images, are intended as substitutes for professional medical advice. Please consult with your doctor about specific medical advice pertaining to your condition(s).
