Physical Health Diagnoses in Athletes

Time to read 12 min


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.

What can blood work tell you?
•      Recommendations based on athletic lifestyle
•      Hormone deficits that might be from over training or nutrition
•      Nutrient deficiencies that you can fix with food
•      Potential immune system issues
•      Are you over training (inflammation signals from certain levels will help identify this)

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.

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.

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.


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.

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.
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.


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.
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.
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.

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

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). 

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