Before you go into your next competitive season I highly recommend you get your bloodwork checked out. When all your bodily systems function right you will get more out of your training.
A basic medical blood work usually includes a crude evaluation of the immune system in terms of immune cell count & basic markers of inflammation, and a crude evaluation of liver function in terms of liver enzymes. For athletes the minimal scope has to be broadened to also look at micronutrient status and hormonal function.
This is the profile I recommend to evaluate if the body is in the best position to go through a hard competitive season.
When all your bodily systems function right you will get more out of your training. Click To Tweet
Why its important : Magnesium is one of the key nutrients in stress tolerance and optimal regeneration. Things I found to happen when athletes optimise their magnesium levels are improved sleep, increased maximal strength, increased power, less joint pain, and less “worries”. One thing I also noticed is that improved magnesium levels improve auditory perception (athletes hear better). I have not yet found out why that happens. There are some sports where that would be an advantage. I believe the biggest benefit for all sports lies in improving regeneration and muscle strength.
Measure : Magnesium has to be evaluated intracellularly, because 99% of the bodies magnesium is stored IN the cells. A regular magnesium test any normal doctor would order measures the magnesium levels OUTSIDE of the cells, in the fluid of the blood (the serum). That does make sense in intensive care scenarios, but it makes no sense for a healthy athlete. The body will try to keep serum Magnesium levels stable. To do that he will steal Magnesium from inside the cells. That is why an intracellular test is way more sensitive to get an honest reading about magnesium status. A fairly good test, which is widely available is the analysis of Red Blood Cell (RBC) Magnesium.
Price Range : Around 2-5$ + doctors charge.
Optimal Range : 5.2-6.5 mg/dLMagnesium has to be evaluated intracellularly, because 99% of the bodies magnesium is stored IN the cells Click To Tweet
Why its important : Zinc is sometimes called the “great detoxifier”. It is involved in many biochemical pathways involving immune function, detoxification and hormonal production. In sports performance terms zinc plays the biggest role in the synthesis of testosterone & other growth hormones, in improving attention span, immune function, and in evaluating mineral absorption issues. When athletes have a lack of libido I think “Zinc Status”. For male athletes this can show as a loss of morning wood as the season drags on, because hard training over many months will deplete zinc if not enough zinc is taken in through nutrition. Less Zinc -> Less Testosterone.
Measure : You can measure your zinc status with a liquid that is called “zinc status”. You put a defined amount in your mouth and depending on the taste of the liquid it can be evaluated if your zinc status is too low. If that is too woooey for you, you can also do a blood lab test. Again, it has to be evaluated in the red blood cells (RBC). So RBC Zinc is the test you want to go for.
Price Range : Around 5-10$ + doctors charge.
Optimal Range : 9-14mg/L
Why its important : EVERY cell of the human body has a receptor for Vitamin D in its cell nucleus. That is where most substances in the human body get synthesised. That is why Vitamin D has such a wide range of effects. Optimising Vitamin D status is athletes has the following effects : improved strength, improved power, less fat/more muscle, better immune function, better mood/confidence, faster tissue regeneration.
Measure : Every lab offers a Vitamin D test. It is important to measure total 25(OH)D. There is also total 1,25(OH), which is the active form. But it is better to measure the “storage” form of 25(OH)D. Also make sure you measure the TOTAL Vitamin D, and not only Vitamin D2 or Vitamin D3. So again, TOTAL 25(OH)D is what you want to go for.
Price Range : Around 20-30$ + doctors charge.
Optimal Range : 60-100ng/ml
Why its important : Ferritin is important in both directions. When it is too low our endurance will be shit. That is because we need Iron from Ferritin to modulate our red blood cells to be able to transport oxygen. No Ferritin, no Iron. No Iron, No functioning red blood cells. No functioning red blood cells, no oxygen transport. No oxygen transport, no endurance.
But Ferritin is also a marker of inflammation. So when the Ferritin levels are too high, then there is inflammation in the body. This can be from a recent infection, but without previous infection it would lead me to evaluate gut health and immune function further.
Together with inflammation, high Ferritin levels are a real danger to our health. That is why we should measure inflammation in the form of hs-CRP, as well. hs-CRP levels should be under 0.5mg/L or chronic inflammation should be suspected, especially when married with normal to high Ferritin levels.
Ferritin levels are also important in the context of thyroid issues, female athletes, and intestinal absorption issues.
Measure : Every lab offers the Ferritin test. It is the same across all labs. Basic Ferritin in blood serum.
Price Range : Around 15-20$ + doctors charge.
Optimal Range : 50-100ng/mlhs-CRP levels should be under 0.5mg/L or chronic inflammation should be suspected, especially when married with normal to high Ferritin levels. Click To Tweet
Most hormonal tests are fairly expensive. That is why I usually only tests hormones when the athletes story leads me to suspect a hormonal cause. But there is one hormone we can consider the Master Hormone, because it guides regeneration. It guides regeneration in terms of tissue healing and regulation of inflammation, but it also guides regeneration in terms of replenishing other steroid hormones like testosterone. And that hormone is DHEA. Luckily, it is also very cheap to test.
Why its important : DHEA serves a key role in regeneration of tissues and the nervous system. It is also the precursor for testosterone and oestrogen. In Chinese medicine DHEA is therefore referred to as the YIN hormone, our adaptive reserve, the oil for our candle. With low DHEA levels you will NOT get the best out of your training and nutrition. Optimising DHEA-S will improve fat burning, muscle building, strength and power levels, perception, and also regeneration.
I see DHEA is a great general indicator of overall systems health. Because if digestion is not good, then DHEA will drop. If the liver is not functioning well, then DHEA will drop. If the immune system is not functioning, then DHEA will drop. If the organism is lacking micronutrients, then DHEA will drop. So for DHEA to be up, everything has to work perfectly in harmony. In Bioflow. So while it is not a great measure to find out what exactly is not functioning right, it is a great indicator to know at how much % our body is running in terms of systems health and adaptive capacity.
Measure : DHEA can be measured in the saliva, the urine and the blood serum. I recommend measuring the sulfurized DHEA (DHEA-S) in the blood serum. Blood reference ranges are WAY lower in most labs, than my recommendations. This has something to do with AVERAGE vs. OPTIMAL. Lab ranges are referenced from the AVERAGE population in that labs country. The sicker the people, the lower the recommended DHEA levels. Canadian labs recommend similar ranges as I do, while the UK recommends values of 3ng/ml for men.
Price Range : Around 15-20$ + doctors charge.
Optimal Range : 7-10ng/ml for men, 4-9ng/ml for women.For DHEA to be in the optimal range, everything in the body has to work in perfect harmony. In Bioflow. Click To Tweet
In total this whole pre-season profile will cost you between 57-85$ in lab charges. Combined with doctors charges and the basic medical blood work measures like immune cell count and hemoglobine you should be able to perform this whole profile for around 250$.
May the FLOW be with you all!
Gerrit Keferstein is a Medical Doctor specialised in Performance & Functional Medicine. He is most known for his work on the optimisation of recovery and adaptation in elite athletes.