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Endurance Journey checks done (what now!)
In part 3 of your Endurance Journey we build on our last conversation about the importance of pre-journey checks. The key today is what these blood and health tests can generally tell you, why you need to be open and honest with a doctor about possible conditions, and how nutrition may well be the solution.
David Katz: It’s a great pleasure to have you with us once again on 32Gi Sports Nutrition, where Mark Wolff and myself, have been taking you through this endurance journey. In our previous podcast we talked about the importance of those pre-journey checks. One of the things Mark really touched on, which is interesting, is the key certain blood work that you should do if you are wanting to get that perfect foundation phase or base to go on and challenge your next endurance. Or if you haven’t done anything for a while, your first endurance endeavour.
How to interpret your blood markers
Mark, the one thing that people need to do once they’ve gone and done these tests is take all that information, but it’s very important to listen to it and take that message and implement in. There’s some real markers I know that you find, because you have a lot of people consulting with you all the time due to your expertise on nutrition, on these tests. There’s a lot of markers that people do need to be aware of, and need to understand on how they need to adapt their diet or their lifestyle to improve that?
Mark Wolff: It’s not always just diet Dave. Sometimes there can be an underlying condition which actually needs medical treatment. Sometimes you’ve got to tell the athlete the hard words which is, you actually need to stop training, or you need to rest and recover or you need to go to rehab or some sort of a treatment.
Bloods for me are definitely representative of health. Is there an underlying condition, isn’t there an underlying condition? Without a doubt you can also see via certain blood tests the level of performance that an athlete can achieve or are they limited due to certain levels being a little bit lower than they should be, in other words, insufficiencies or deficiencies in the blood.
Why full bloods are worth it
DK: Mark, talking about that, as you said, yes a lot of it can lead to nutrition but it’s a lifestyle, its lifestyle changes. There might be something that’s impacting your health and has got nothing to do with what you’re consuming, but it’s a certain aspect of your lifestyle you do need to address, and that’s really where these blood tests point people isn’t it?
MW: Yes, I think so, for sure and there’s many blood tests you can run. Obviously you’ll look at a full blood count because it’s quite representative of quite a number of markers. Depending on a person’s medical history, you might want to even look at allergy testing and specific things such as thyroid or more hormone testing in some men, testosterone tests.
Anything that would be representative of maybe something that could be an underlying condition because there’s a genetic predisposition to some sort of an illness, based on family history or family medical history. When it comes to an athlete, there’s quite a number of bloods that I definitely like to look at and I’ll run through a few right now.
The danger of low red blood cells (can you say anaemic?)
I’ve actually pulled up a few blood tests in front of me, just to get a glance and it’s actually triggered quite a few things. One of the most important things I look at is, for example, is definitely the red cell count and haematocrit levels. The reason being is that you’re looking at blood pooling and your major oxygen carrier are your red blood cells.
If it’s low and there’s not sufficient red cells, even for iron to bind to, I mean this is typical of anaemia in an athlete and definitely it will undermine your ability to perform. It can also trigger fatigue; it can trigger nausea, generally definitely not healthy and something that needs to be looked at. In this case a doctor would obviously prescribe iron and it’s something that would be absolutely necessary.
When it comes to certain other bloods, one of the other things that I would look at is something like, maybe the hemoglobin levels and haematocrit levels, the red cell counts are absolutely normal. I’ve seen athletes with absolutely stellar haemoglobin haematocrit and red cell counts, which means they’ve got this unbelievable engine that they can tap into and utilise.
Why so many athletes are Vitamin D deficient
In one particular case I noticed that the athlete had amazing bloods but on the other hand the Vitamin D levels were so deficient that no matter how much training he did, his immune system was put at risk. This means that he was more susceptible to illness. It doesn’t matter how much you train, the problem is if the illness hits you, it’s very difficult to achieve and reach those training adaptations that make you stronger over time.
The last thing you want to do is get sick, so in that case that athlete had to actually go onto a high Vitamin D dose in order to be able to get his Vitamin D levels up. It does take time.
In another case I noticed, we spoke about iron insufficiency or deficiency, in other words anaemia; in some cases I’ve seen bloods where the ferritin has been excessive. In other words, a very high iron storage disorder and this can make you feel absolutely terrible. It’s definitely indicative of something which is called hemochromatosis which is usually genetic and treatment would be required, sometimes, not always.
Don’t take excessive Iron unless it’s prescribed
I’ve also seen athletes that take iron when they’re not supposed to. You should never take iron unless it’s absolutely prescribed by a doctor. There needs to be a reason for it.
In other case studies and something that I also look at very often, is urea and creatinine levels. Urea we know is made in the liver and passed out through the kidneys. If the kidneys aren’t functioning properly, you can actually see that that can be indicative of high urea counts.
Elevated creatinine levels can indicate also that the kidneys are not functioning normally, however, excessive training or over-training, even dehydration can also lead to elevated creatinine levels. These are things that you can look at.
What elevated creatinine levels could mean
Very often I’ve seen bloods where the kidney function is normal, there’s been changes in urea and creatinine levels and that generally boils down to dehydration, but in some cases you can see the kidneys are absolutely battling and then the athlete needs to take a back step and say, look, this is something that’s critical, I need to have it looked at. Further investigation is required, the doctor needs to be approached and testing needs to be carried out to see exactly what the issue is. You should never leave things like this. They are very, very important.
A couple of weeks ago I had a personal incident where I felt three days after a specific workout, due to dehydration, because of a vasoconstrictor which I took, had impacted me quite significantly. I woke up three days after that particular session with severe kidney pain, especially on the left side. It made me wonder what was going on.
There’s a condition called Rhabdomyolysis which I actually thought possibly is this the onset of it. It wasn’t Rhabdomyolysis. It turned out to be my kidneys were overworking. My creatinine levels were absolutely through the roof. It was absolutely due to the severe dehydration that I experienced on the weekend, due to consuming a vasoconstrictor because of a post-nasal drip.
How to get a snapshot of your health
Even something so small and something that you might think is so insignificant can impact a person. I wouldn’t have actually battled on that session if it was three or four hours long, but the session was five and a half hours and that little bit of a stretch is what caused all those issues.
Bloods absolutely don’t lie, and I think it’s something that anybody should look at to see is there an underlying condition. We all take our cars for services and I’ve mentioned this before. We pay a fortune having our oil filters replaced and having everything checked to make sure the car is fine and safe to travel in.
In all honesty, we’ve got a human body. I’d rather take the money and spend it on checking that my own vehicle is in good working order and in order for me to know that, bloods are so critical. It’s something that I do regularly because it really gives a snapshot of my health.
I even have noticed over the last, I would say six to nine months, due to changes that I’ve personally made in my diet to try and modify certain levels of my bloods, there has been a massive improvement in certain bloods which actually help from a sports performance level.
How bloods give you an insight into nutrition
That, for me, it shows that nutrition is so key, especially if you know what to eat around what kind of blood tests you’ve been faced with. In actual fact, just as an example, if you do have a high iron disorder, you need to get rid of that iron. In the case of that, you would need to donate blood, possibly on a regular basis to try and lower the risk of hemochromatosis.
The other thing is you would need to cut out high iron foods in your diet in order to be able to lower it. For everything that you pick up, there is a way of dealing with it and controlling it, but the best thing to do, go to your GP or your physician, get them to run a range of bloods for you. Check some mineral levels, check some vitamin levels, check the full blood count. If there is any family history, tell your GP or your physician about it and make sure they take that into account when running the blood tests.
When you embark on your endurance journey, you want to be absolutely sure that you have complete peace of mind that there is no underlying condition that when you put stress on your body, it will cause a major health issue in your life.
DK: Mark, some fantastic case points there and you’ve touched on some really important stuff. I think the next step is really to see how people take that and adapt it to their nutrition to get that base on track or to get their health back on track. We will save that for another podcast.
Mark has plentiful research that he has done on blood tests. If you do want to ask more questions, please do email email@example.com or hop onto our website, 32gi.com. From Mark Wolff and myself, Mr Active, David Katz, we’ll catch up with you next time.