Understanding your body’s key biomarkers and their response to stress can safeguard you against overtraining syndrome and enable you to optimise your training regime.
As an endurance athlete, you can optimise your performance by analysing and fine tuning key metabolic markers. There are lots of conflicting viewpoints out there on what exactly you need to test and that’s why we’ve designed this panel of blood tests to keep things simple, insightful and actionable. This panel includes a cortisol test.
Our Endurance Check measures key drivers of performance including your metabolic hormone function (including a cortisol test), levels of inflammation in the body, muscle damage, oxygen carrying capacity and bone health. We also test the function of your body’s essential organs to ensure you’re building on a solid foundation.
This hormone analysis includes an oestrogen, testosterone and progesterone test, as well as an LH, FSH and prolactin test. These sex hormones (in conjunction with adrenal and thyroid hormones) exert powerful effects on the body. Knowing the function and levels of these hormones is a positive step in creating hormone balance and achieving wellbeing.
Too much oestradiol (oestrogen) is linked to acne, constipation, loss of sex drive, depression, weight gain, PMS, period pain, and thyroid dysfunction. The effects of low oestradiol are evident in menopause and include mood swings, vaginal dryness, hot flashes, night sweats and osteoporosis.
The sex hormone produced mainly in the ovaries following ovulation and is a crucial part of the menstrual cycle. Progesterone helps to combat PMS and period pain issues, assists fertility and promotes calmness and quality of sleep.
Governs the menstrual cycle, peaking before ovulation. Raised LH can signal that a woman is not ovulating, is menopausal or that the hormones are not in balance. A high LH/FSH ratio can indicate Polycystic Ovarian Syndrome (PCOS).
Stimulates the ovary to mature an egg. High levels indicate poor ovarian reserves which means the quality and quantity of eggs may be low. This doesn’t necessarily mean that pregnancy is impossible, but it may be more difficult to achieve.
Normally this ratio is about 1:1 meaning FSH and LH levels in the blood are similar. In women with polycystic ovaries the LH to FSH ratio is often higher e.g. 2:1 or even 3:1
High levels commonly seen in polycystic ovarian syndrome (PCOS) which can lead to difficulties in conceiving. Symptoms can include irregular periods, loss of hair from the head, excess facial and body hair, unexplained weight gain and acne.
Most testosterone is strongly bound to sex hormone binding globulin (SHBG). This test measures the proportion of unbound testosterone which is available to the body's tissues.
Sex Hormone Binding Globulin (SHBG) is a protein that binds tightly to testosterone and oestradiol. Changes in SHBG levels can affect the amount of hormone that is available to be used by the body's tissues.
IGF-1 mirrors GH excesses and deficiencies but its level is stable throughout the day, making an IGF-1 test a useful indicator of average GH levels.
Also known as Somatomedin C. IGF-1 is an indirect measure of the average amount of GH being produced by the body.
Two of the most important hormones that impact athletic performance are cortisol and DHEA-S, the long-lasting stress hormones produced by the adrenal glands. Cortisol has a catabolic effect which mobilises the body’s nutritional resources for fuel. DHEA-S has an opposing anabolic effect and converts food into living tissue. In order to achieve your fitness goals cortisol and DHEA-S must be in proper balance.
The cortisol test measures 'the stress hormone' cortisol which mobilises the body’s nutritional resources in stressful situations. Prolonged elevation of cortisol can cause fatigue, immune dysfunction, and impact sex hormones.
A long-acting adrenal hormone which regulates energy production, the immune system, brain chemistry, bone formation, muscle tone and libido. DHEA-S is converted by the body into testosterone and other sex hormones.
Your thyroid gland produces hormones that regulate growth and energy expenditure. Thyroid disorders are quite common, and many people don’t have any symptoms at all. This thyroid test screens for the thyroid hormones that play a key role in regulating the body’s metabolism.
Communicates with the thyroid gland to produce T3 and T4 which regulate metabolic functions. High TSH thyroid test levels indicates an underactive thyroid, and low levels an overactive thyroid.
Measures the thyroxine that is freely circulating and able to regulate metabolism. High FT4 thyroid test levels indicate an overactive thyroid, and low levels an underactive thyroid.
Measures the triiodothyronine that is freely circulating. High FT3 thyroid test levels indicate an overactive thyroid, and low levels an underactive thyroid.
Vitamin B12 is an essential vitamin found in meat products and certain algae such as seaweed. It helps maintain healthy nerve cells and red blood cells and is also needed to make DNA, the genetic material in all cells. Both high and low vitamin B12 blood test levels may indicate an underlying problem. Low levels can suggest anaemia, a parasite or hyperthyroidism, whilst high levels can be a sign of liver disease, diabetes or kidney failure.
Holotranscobalamin represents only 10-30% of the Vitamin B12 circulating in the blood but is the ONLY form of Vitamin B12 that is taken up and used by cells of the body, hence it’s other name - ACTIVE Vitamin B12.
This ferritin test is a measure of how much iron you have stored in your body. Low ferritin can be a sign of anaemia caused by iron deficiency. This test can also be used to investigate iron overload syndrome (haemochromatosis) which is an inherited condition where your body cannot remove excess iron.
The ferritin concentration within the blood stream reflects the amount of iron stored in your body and is reduced in anaemia.
Calcium and vitamin D play a critical role in maintaining bone health. When you don’t get enough calcium, you increase your risk of developing osteoporosis and stress fractures. This blood test measures your total and corrected calcium levels, your vitamin D levels, and also checks for gout.
Plays a critical role in developing and maintaining your overall bone health. If the total calcium result is abnormal, a corrected calcium calculation provides further information.
Although called a vitamin, vitamin D (25-OHD) is actually a steroid hormone which is activated by sunshine on the skin. It is essential for bone strength as it helps the intestines absorb calcium.
If too much urate is produced or not enough is excreted, it can accumulate and lead to gout – an inflammation that occurs in joints.
Most phosphate in the body comes from foods such as beans, peas and nuts, cereals, dairy products, eggs, beef, chicken and fish contain small amounts of phosphate. Phosphates are vital for energy production, muscle and nerve function, and bone growth.
Magnesium and calcium work together closely to maintain strong bones, and magnesium deficiency has been associated with an increased risk of osteoporosis.
Lipids and cholesterol are fat-like substances in your blood. Some are necessary for good health, but when you have a high level of cholesterol in your blood, a lot of it ends up being deposited in the walls of your arteries and other vital organs. Lifestyle choices including diet, exercise and alcohol intake can all influence cholesterol levels and your risk of developing heart disease.
High total cholesterol is a risk factor for cardiovascular disease.
LDL (low density lipoprotein) cholesterol is often called ‘bad cholesterol’ because it contributes to plaque, a thick, hard deposit that can clog arteries and make them less flexible.
HDL (high density lipoprotein) cholesterol is often called ‘good cholesterol’ and is protective against atherosclerosis.
The main storage form of fatty acids in the body. Elevated triglyceride levels may contribute to hardening of the arteries, and increase the risk of heart disease or stroke.
Non-HDL cholesterol is considered an effective lipid measurement for assessing cardiovascular disease risk as it is believed to reflect levels of 'bad' cholesterol. Other risk factors include smoking, high blood pressure, diabetes, obesity, physical inactivity, age, gender, ethnicity and family history.
Insulin resistance can lead to difficulty losing weight, distinct abdominal fat, fatigue, bloating and sugar cravings. Identifying insulin resistance early and committing to lifestyle changes can ultimately help the progression to diabetes.
If you have diabetes your body doesn't process glucose effectively.
A hormone produced by the pancreas that helps to control blood glucose levels and plays a role in controlling the levels of carbohydrates and fats stored in the body.
The HOMA score is a standard measure of insulin resistance, It is calculated as follows: (Blood Glucose X Fasting Insulin) / 22.5.
The diabetes test counts the number of red blood cells that are glycosylated (attached to sugar) and reports it as a percentage, e.g. if 7 out of every 100 red blood cells are attached to sugar, the HbA1c result will be 7%.
HbA1c can be expressed as a percentage (DCCT unit) or as a value in mmol/mol (IFCC unit). Since 2009, mmol/mol has been the default unit.
The full blood count is used as a broad screening test to check for such disorders as anaemia (decrease in red blood cells or haemoglobin), infection, and many other diseases. It is actually a group of tests that examine different parts of the blood. Results from the following tests provide the broadest picture of your health.
Responsible for carrying oxygen around the body. A high count can increase the risk of heart attack or stroke, whilst a low count can mean your body isn’t getting the oxygen it needs.
A good measure of your blood's ability to carry oxygen throughout your body. Elevated haemoglobin can be an indicator of lung disease, whilst a low result indicates anaemia.
A measure of the percentage of red blood cells in the total blood volume. Elevated haematocrit can increase the risk of heart attack or stroke.
Mean corpuscular volume (MCV) is a measure of the average size of the RBCs. The MCV is elevated when RBCs are larger than normal, eg in anaemia caused by vitamin B12 deficiency. When MCV is decreased, RBCs are smaller than normal as seen in iron deficiency anaemia.
Mean corpuscular haemoglobin (MCH) is a calculation of the average amount of oxygen-carrying haemoglobin inside a red blood cell. Large RBCs are large tend to have a higher MCH, while small red cells would have a lower value.
Mean corpuscular haemoglobin concentration (MCHC) is a calculation of the average concentration of haemoglobin inside a red cell. Decreased MCHC is seen in iron deficiency anaemia and thalassaemia.
Red cell distribution width (RDW) is a calculation of the variation in the size of your RBCs. In some anaemias, such as pernicious anaemia (due to vitamin B12 deficiency), the amount of variation in RBC size causes an increase in the RDW.
Responsible for fighting infection. A high count can indicate recent infection and even stress, whilst a low count can result from vitamin deficiencies, liver disease and immune diseases.
Basophils are a type of white blood cell. Basophils can increase in cases of leukaemia, long-standing inflammation and hypersensitivity to food.
A type of white blood cell. Can increase in response to allergic disorders, inflammation of the skin and parasitic infections. They can also occur in response to some infections or to various bone marrow malignancies.
A type of white blood cell. Can increase in response to infection as well as inflammatory disorders, and occasionally with some types of leukaemias. Decreased monocyte levels can indicate bone marrow injury or failure and some forms of leukaemia.
A type of white blood cell. Can increase with bacterial or viral infection, leukaemia, lymphoma, radiation therapy or acute illness. Decreased lymphocyte levels are common in later life but can also indicate steroid medication, stress, lupus and HIV infection.
A type of white blood cell. Can increase in response to bacterial infection, inflammatory disease, steroid medication, or more rarely leukaemia. Decreased neutrophil levels may be the result of severe infection or other conditions.
Responsible for blood clotting and healing. A high count can indicate a risk of thrombosis, whilst a low count can lead to easy bruising.
Your liver processes drugs and alcohol, filters toxic chemicals, stores vitamins and minerals, and makes bile, proteins and enzymes. This liver function test examines enzymes and other markers for evidence of damage to your liver cells or a blockage near your liver which can impair its function.
Bilirubin tests are use to screen for or to detect and monitor liver disorders or haemolytic anaemia.
Alkaline phosphatase (ALP) is an enzyme located mainly in the liver and the bones. High levels can indicate liver disease.
Aspartate aminotransferase (AST) is an enzyme created mainly by the liver and the heart. High levels can indicate damage to your liver caused by alcohol, drugs or hepatitis.
Alanine aminotransferase (ALT) is an enzyme mainly produced by the liver. A good indicator of liver damage caused by alcohol, drugs or hepatitis.
Gamma-glutamyl transferase (GGT) is a liver enzyme which can be used to diagnose alcohol abuse as it is typically raised in long term drinkers.
Albumin is a protein which keeps fluid from leaking out of blood vessels, nourishes tissues, and carries hormones, vitamins, drugs, and ions like calcium throughout the body. Albumin is made in the liver and is sensitive to liver damage.
A measure of all of the proteins in the plasma portion of your blood. Proteins are important building blocks of all cells and tissues - they are important for body growth and health.
Your kidneys filter waste from your body and regulate salts in your blood. They also produce hormones and vitamins that direct cell activities in many organs and help to control blood pressure. When the kidneys aren't working properly, waste products and fluid can build up to dangerous levels creating a life-threatening situation.
Helps regulate the water and electrolyte balance of your body, and is important in the function of your nerves and muscles. Too much sodium can indicate kidney disease.
Minor changes in serum potassium ca have significant consequences. An abnormal concentration can alter the function of the nerves and muscles for example, the heart muscle may lose its ability to contract.
Chloride, like sodium, helps to maintain the balance of fluid in the body. Raised levels can be caused by eating too much salt, dehydration, diarrhoea, certain medications and also kidney disease.
Higher than normal levels suggests trouble maintaining pH balance either by failing to remove carbon dioxide or because of an electrolyte imbalance. Elevations may be seen with severe vomiting, chronic lung problems and some hormonal disorders. Low levels may be seen with chronic diarrhoea, diabetic ketoacidosis and kidney failure.
A high concentration of this waste product can indicate dehydration or that your kidneys aren’t working properly.
A waste molecule generated from muscle metabolism, and an accurate marker of kidney function.
The estimated glomerular filtration rate (eGFR) measures how well your kidneys filter the wastes from your blood and is the best overall measure of kidney function.
Inadequate recovery from exercise or overtraining can result in inflammation and muscle damage. In addition to c-reactive protein and creatine kinase, this panel also measures homocysteine which is another recognised risk factor for cardiovascular disease, as well as osteoporosis and Alzheimer’s.
When muscle cells are injured creatine kinase enzymes leak out of the cells and enter the bloodstream. Prolonged elevated creatine kinase after periods of rest can be a sign of overtraining.
A high-sensitivity C-reactive protein (hs-CRP) test measures low levels of CRP and may be used to help evaluate an individual for risk of cardiovascular disease
LDH is an enzyme required during the process of turning sugar into energy for your cells. Only a small amount is usually detectable in the blood, however, when cells are damaged they release LDH into the bloodstream.
An amino acid normally present in very small amounts in all cells of the body. Homocysteine is a product of methionine metabolism - one of the 11 ‘essential’ amino acids that must be derived from the diet.
Take test 7 days before predicted date of menstruation (if known). If menstrual cycle is 28 days, test on day 21 (where day 1 is the first day of bleeding).
Fast from all food and drink (other than water) for at least 8 hours, and no more than 12 hours prior to your test.
Take your form to one of our affiliated collection centres to have your sample taken.