When I was a kid, I was blood tested and had low iron and supplemented to raise my levels. I took the pills and drank orange juice to help absorption. Ten years later in college, I read Dr. Colgan’s Optimum Sports Nutrition and was fascinated with his use of blood testing with athletes. When I had national level athletes in the late 90s, I went on Netscape Navigator (young coaches have it good) to find a way to get tested and found very little options. It was hard because most of the clinics like Quest Diagnostics required a physician’s script and having a full screen without symptoms required arm twisting and prevention versus reactionary medicine was not the norm. During the time my therapist in Tampa was doing blood draws 4-6 times a year, a frequency I looked at as being the norm later. He was a member of the Life Extension Foundation and was looking at dozens of biomarkers to improve his health and performance. We settled for Sun City Diagnostics, in the heart of retirement centers in the west coast of Florida. We were able to pick from a menu of tests like Sushi and get the blood draw. Two weeks later we got the results mailed to us and we were able to review our program holistically. Now we have more options online and new innovations such as mobile health (HRV) and validation monitoring (power testing equipment). Teams are finding the winning edge with blood, saliva, and urine testing, but I will focus on blood testing in this entry and review three primary options that are shaping the future of health and performance. First let’s talk about what you can do with the information first, and practical approaches to managing the data in sport.
Blood Testing is nothing new, and great coaches have leveraged blood testing for years.Legendary coach Joe Vigil explained in great detail in 1999 about what specific blood tests he used at the Level III school. Unfortunately, many coaches are not testing at all, save for the physician’s health screen done in the beginning of the year.
His professional runners had clauses in their contracts based not only on race performances but also on lab testing. They tested four times per year and were expected to either maintain or improve their lab numbersâ€¦.and if they followed the program, they did! Before Deena’s American record 15k performance at Jacksonville’s Gate River Run, she was unsure whether she could run the pace Coach Vigil predicted based on her lab results. However, Coach Vigil instructed her to go out at record pace. She ultimately ran within a few seconds of his predicted time and might have hit it exactly if not for wind variation.
Unfortunately momentum stopped because in the Bay Area, Victor Conte got in trouble for doping and much of the blood testing benefits got lost in the maze of drug and media nonsense. Now ten years later we are back to blood testing with the Quantified Self movement and mHealth. I have found that blood testing does the following three things.
Objective Data- Slow metabolism, low energy, insane hormone response to weight training? How do we know? Blood testing is simple objective testing and very few teams and facilities are doing it right. Screening is helpful and the data is objective, but the key is having the data mean something to the athlete. Not sharing the data to the athlete is not a good idea as they loose accountability and are not engaged. Education via data experimentation is vital. Also blood testing allows for information we know is objective, something we need to know such as hormone analysis, overtraining markers, nutritional status, and wellness measures. Good data needs three data points to find a trend. Screening once a year is autopsy data, interesting but too little and too late!
Behavior Modification- Athletes are engaged in blood testing when the data and how it interacts with their performance and lifestyle. Just collecting the data can enough for athletes who are interested in training, but most need to see the data to change behavior. If you are not doing your homework and not studying, tests and exams that are not graded don’t do anything. Good testing reinforces athletes to keep doing well and poor testing is forcing the athlete to face a measured evaluation of their decisions. Coaches can see athletes daily to train, but nutritionists are not spotting athletes with three or more meals a day.
Gages Nutrition Status– Athlete are often lean and look the part, but sometimes they are not eating enough to gain mass or keep fueled properly. Often they are anemic or having problems with deficiencies such as low zinc and vitamin D. We have heart rate monitors for the heart, but no stomach monitor for the digestive system. Blood testing allows everyone to see what is going on inside the body with nutritional patterning. High B-12 is often a pattern of too many supplements and too little fruits and vegetables, as I have seen athletes test poorly on nutrient status but were chronically high in B-12.
You have three options to take your training into your hands and empower your program is you are in the US. You can see a doctor, get tested independently, or get directed by a value added service. I like a combination of the three since no solution is perfect. If you want to do the two independent options, you can choose a testing company to help.
[EDITOR’S ADDITION: Paid Content]
Health Labs has over 2,000 test centers around the country. This is an important point to keep in mind because it makes it easy to find a test center somewhere close to you. Also, all of their testing is done by Quest Diagnostics. Quest Diagnostics is one of the most reputable and respected labs in the world so you know you can trust the results. Health Labs stands out for their fast, affordable and private results. They offer tests for practically anything you would want.
Direct Labs- Not rocket science here, Direct Labs is a discount testing company that provides panels for competitive prices. Some of their panels are crazy like their ION Profile w/40 Amino Acids-METAMETRIX KIT that is nearly a 1000 dollars. Some tests are dirt cheap and some packages are promising. They are not available in every state and send the raw lab reports via MyDLS online and show clinical ranges. Some ranges are not sport science valid and some are fine such as Vitamin D. Athletes may have the same scores with some tests as regular people, but it may be more important to have good biomarkers when competing at a high level. There are a ton of companies like this that simply provide menu options for testing and the prices are nearly the same everywhere as they deal with resellers. One of the challenges is combining more tests as they don’t always have compatibility and may require separate testing. I have had athletes use Direct Labs a few times over the last ten years and the service is without problems.
Wellness FX- Touted by Tim Farris and crossfit people, Wellness FX is value added service that provides two levels of support with nutritionists and medical professionals. They provide a consultation lasting 20 minute or up to 40 (Depending on panel purchased). Based on San Francisco, the heart of the QS movement and start-up capital, they provide a web portal to show the data as they expect retesting every 120 days to monitor your health. They currently have three panels, a fitness panel, thyroid panel, and a performance panel that includes an array of biomarkers. Wellness FX is strongly connected with cross fit with Mobility WOD founder Kelly Starrett pushing the system. I love the Performance Panel, but at $699 the cost is prohibitive if one can get a similar panel for half that and blood testing should be done four times a year. They seem to be focused on more health and disease management than performance, except for an endorsement with Bay Area performance center Sparta. What new direction they are going will be important to the QS movement as they are one of the providers to data. I like that they provide choices for consultations, and they offer a range of professionals to talk to. If they are to enter the sports performance market, they will need to collaborate more with sports science and invest in software that can do analysis on training.
InsideTracker- I have used InsideTracker and like their system to monitor athletes as their product is based on fitness and performance. Over a year ago I was looking for a better option for blood testing and found them on the QS tool area and tried them out. I like the panel as it covers the basics, and their service is perhaps their strongest area. What is key for elite athletes is the ability to do a blood draw at the very precise time to data mine acute biomarkers. They can schedule on site draws at hotels for athletes looking to get insight on load tolerance and provide nutrition tools and web software to help build interventions based on nutrition and training. They provide .CSV export for athlete management systems and have invested a lot of money on their backend analytics engine B.R.I.A.N, a system able to predict injury trends and is now collecting HRV data and other objective measures to solve problems for teams. Their CSO spoke at the MIT Sloan Sports Analytics Conference and is driving innovation towards the fitness consumer and elite sport. In order to grow impact daily, a mobile app is going to be necessary to coach individual athletes without being too invasive or pestering. The hardest aspects of helping athletes is nutrition, because it’s not something that is fixed by a few meetings with a dietician or workbook.
In my next series I will go into some of the best nutritional resources for coaches such as books, blogs, and organizations. I have used many different consultants and experts over the years and found nutrition to be the most demanding next to sleep. The future will be mobile devices, but conventional technology is here now for coaches to take advantage of.