By Wild Rice Wellness / November 22, 2022

Laboratory Evaluations Every Athlete Should Have Yearly

For optimal training and recovery

Athletes of every level spend a lot of time and money on the perfect training plan, recovery tools, and making sure that their macros and fueling are on point (which is all important stuff!) but one place I see that isn’t totally dialed in is their actual health. You might be thinking, wait, aren’t athletes generally healthy? So why would they need to focus more on this? Well, I am here to tell you that even though, yes, athletes are generally healthy, there is usually room for improvement. I'm Alison Percowycz, Nurse Practitioner at Wild Rice Wellness an Integrative and Functional Medicine Practice and see time and time again the micronutrient deficiencies, anemias, and other areas that could use optimization in athletes that can affect training, performance, and recovery. In order to address these you have to test, you can’t just guess! Athletes should have routine labs done at least yearly, if not multiple times (like before and after a big training cycle) to tune into where there might be deficiencies or insufficiencies that could help improve their performance and most importantly, their health. 

The following is a list of lab tests that, at a minimum, every athlete should have done at least yearly. These can typically be done by your regular healthcare provider and done at any standard lab. However, what the labs and conventional medicine declares as “normal” is often not optimal for peak performance. I work with athletes located in Colorado (and soon Florida!) on making sure their health is as fine tuned as their training plan. The following are the basic labs that I recommend to be drawn at least yearly:

1. Complete Blood Count:  Even this one simple test can give indicators of inflammation, anemias, nutrient deficiencies and more. 
2. Complete Metabolic Panel -This test is a good overview of kidney and liver function, fasting glucose, electrolytes levels (sodium, potassium, calcium)
3. Hemoglobin A1c - This is an average level of the previous three months blood glucose levels and can be an indicator of blood glucose balance/regulation and diabetes
4. Fasting insulin - This is often a more sensitive and earlier detector of blood glucose dysregulation than the A1c or fasting glucose 
5. Full thyroid panel (TSH, T4, T3, reverse T3 and antibodies) - The thyroid is vital for energy, mood, metabolism and heart rate regulation, oxygen consumption and more. High or low thyroid conditions can contribute to weight gain/loss, infertility, irregular periods, difficulty with temperature regulation, hair loss, fatigue and so much more. 
Iron panel + ferritin - energy metabolism, oxygen transportation in the body, low iron can result in fatigue, hair loss, thyroid dysfunction, difficulty with endurance and recovery 
6. Vitamin B12: The B vitamins and B12 in particular are critical for red blood cell production, DNA and protein synthesis, and energy production.
7. Vitamin D: This vital hormone affects immune function, bone health, recovery from training and much more. Most people are deficient or insufficient unless supplementing, even in Sunny Colorado!
8. Highly sensitive C-reactive Protein (HsCRP): This is a general marker of inflammation. Training of any kind but especially high volume training is inflammatory so we want to keep a gauge on this to make sure the body is not overly inflamed where we will need to look at other potential causes. (side note: this lab should not be done after a workout as it can be falsely elevated).

It is important to remember that what is considered "normal" is often times not optimal for an athlete and working with a practitioner that can dig deep into the labs to see where there are potential deficiencies or insufficiencies is vitally important. In addition to the basic labs above, below is a list of more in depth testing from an integrative and functional approach that can help get to the bottom of underlying issues that athletes may face that can be addressed to get them to peak performance and health. These are not recommended for everyone but if there are nagging injuries, fatigue, GI disturbances or training plateaus these may be good additions:

1. RBC mineral testing (magnesium, zinc, copper) - These elemental minerals are critical for operating at peak performance, optimal recovery and immune function. Serum studies are do not as accurately reflect the true stores.
2. 4 point salivary cortisol: This test may be good if you are having difficulty maintaining your training volume or feeling extra fatigued, or have that “tired but wired” feeling that leaves you tired during the day but then have difficulty falling asleep or getting good sleep at bedtime. 
3. Gut microbiome testing: This can be good for any ongoing GI symptoms like constipation/diarrhea/indigestion but also gives indicators of digestion, inflammation, immune function, toxic load, microbiome balance, presence of beneficial or pathogenic bacteria or parasites and relative abundance of microbes. 
4. Hormone testing (serum testing or DUTCH specialty test): Hormone testing can give valuable insight into the different sex hormones which can significantly affect training in men and women. Serum testing can be done at a standard lab, and the Dutch test is a comprehensive test done at your home via dried urine/saliva to look at hormones and hormone metabolites and areas that need attention. 
5. Micronutrient testing (Genova Diagnostics NutraEval or Metabolomoix+): The most in depth micronutrient testing out there, which looks at antioxidant, vitamin, and mineral levels, essential fatty acid ratios, amino acid levels and balance, digestive support, cellular energy and mitochondrial markers, toxins and oxidative stress markers. This can help to make sure nutrition/supplementation is optimal on every level. This is one the top tests for athletes looking to get the most out of their training and recovery.
6. Essential and Metabolic Fatty acid profile: This is done at many standard labs and looks at the balance of the different fatty acids, looking specifically at omega 3 levels which are anti-inflammatory and can enhance training and recovery. 
7. Nutrigenomic testing: There are more and more DNA type tests looks at your DNA and how different foods interact with it, gives insight on how your genes interact with environmental factors like nutrition, digestion, energy/methlyation, inflammation, detoxification.

If you are in Colorado (soon Florida) and looking for a practitioner who can help with ordering, interpreting and providing actionable steps to improve your labs and your health. Please visit my website Wild Rice Wellness to book a free 15 minute consultation to discuss more about your health and your health needs! 

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