Blood Testing in Athletics

Caroline Kovacs

How do athletes use this information to maximize performance?

Ever tired of those annoying blood tests at the doctor’s office? While they can seem pesky in the moment, those vials of blood contain crucial information to help monitor and maintain a person’s overall health. Blood tests provide baseline information for different biomarkers involved in normal bodily functions and can help detect early-stage diseases (1). For athletes, blood testing is also used as a tool to prevent injuries and enhance athletic performance. The blood testing industry is fast-growing, so numerous companies are promoting athletic blood tests as a way to unlock peak performance and gain an edge (2).

Studies have shown that blood tests can reveal deficiencies and imbalances in athletes’ blood that can impact overall health and performance. Some key blood tests used by athletes are Complete Blood Count (CBC) tests; iron, transferrin, and ferritin panel tests; Comprehensive Metabolic Panel (CMP) tests; vitamin D tests; and hormone tests.

The CBC is one of the most commonly performed blood tests. It provides information on the number of red blood cells (RBCs), white blood cells (WBCs), and platelets; measures hemoglobin levels; assesses variations in RBC volume and size; and determines the average RBC size with a mean corpuscular volume (MCV) test. RBCs are important because they deliver oxygen to working tissues throughout the body. The maximum rate at which RBCs deliver oxygen is called VO₂ max. More RBCs circulating in the bloodstream result in more oxygen being delivered to tissues and a higher VO₂ max, giving athletes with higher RBC counts a competitive advantage, especially in endurance sports (3). A low RBC count is known as anemia, which leads to weakness and fatigue (4). WBC counts are also significant because these cells protect the body from infection; a WBC count that is too high or too low can be a sign of infection or inflammation that needs to be addressed (though slightly low WBC counts are often common in endurance athletes) (6,7).

Red Blood Cells: Function and Structure

Red blood cells (RBCs) (1).

  The iron, transferrin, and ferritin panel test measures the amount of iron in the body. Iron is essential for helping RBCs carry oxygen to muscles; without sufficient iron, RBCs cannot function effectively, negatively affecting not only athletic performance but also overall health (8). Along with testing iron levels, athletes typically test their transferrin (a protein that regulates the absorption of iron) and ferritin (a protein that stores iron in the body) levels to better understand their body’s iron metabolism (9). Low iron and poor iron-metabolism can lead to iron deficiency anemia, an affliction that affects a significant percentage of endurance athletes (17 percent of males and 50 percent of females) (8). This gender disparity is primarily due to menstruation, which increases iron loss in female athletes, but is also impacted by dietary iron intake and absorption (10). Research reinforces the use of iron supplements to address performance issues related to iron deficiency, finding that low-moderate doses of iron supplementation resulted in improved aerobic performance and endurance in female athletes (11).

The Comprehensive Metabolic Panel test provides information about the body’s metabolism and chemical balances, electrolyte panel tests that check for other electrolyte imbalances, and blood tests that screen for specific diseases or allergies (3). Among other things, the CMP test can assess liver and kidney function, helping diagnose conditions like diabetes and hypertension. It also evaluates the efficacy of an athlete’s metabolism, and abnormal test results may indicate a need to make dietary changes to optimize fitness. The CMP test may also include a test for levels of inflammatory markers in the blood like C-reactive protein (CRP), which can indicate that an athlete is overtraining and experiencing excessive inflammation, leading to a slower recovery and higher risk of injury (3).

Vitamin D is a key micronutrient that works towards maintaining healthy immune function, protein synthesis, muscle function, cardiovascular function, inflammatory response, cell growth, and musculoskeletal regulation (12). Because sunlight is essential in the synthesis of vitamin D, many athletes have been found to suffer from vitamin D deficiency, particularly in colder climates and temperatures (13). Vitamin D deficiencies have been linked to bone injuries, particularly stress fractures and poor immune function in athletes (13). To monitor their levels and maintain optimal health, athletes use vitamin D tests. Because of the difficulty of meeting vitamin D needs through diet alone, athletes are often encouraged to take vitamin D supplements, aiming for a level of 50 mg/ml for optimal performance (13).

The results of these blood tests can guide athletes and trainers in creating personalized nutrition and workout plans that optimize performance. Many of the issues identified by blood tests can be addressed through dietary changes, supplements, and lifestyle modifications (including sleep, exercise and stress management). These changes can improve an athlete’s strength, speed and stamina, and prevent injuries, helping them reach their full potential.

References:

  1. ‌Lab, A. (2023, November 10). Blood Testing for Optimal Health and Performance. Athletic Lab. Retrieved from https://www.athleticlab.com/blood-testing-for-optimal-health-and-performance/
  2. Licalzi, D., & Snethlage, C. (2023, October 17). Blood Testing for Athletes: Improving Performance and Outsmarting the Competition. InsideTracker. Retrieved from https://www.insidetracker.com/a/articles/blood-testing-for-athletes-improving-performance-and-outsmarting-the-competition
  3. ‌‌Cleveland Clinic. (2022, December 6). Blood Tests: Types, Results & How They Work. Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diagnostics/24508-blood-tests
  4. Low red blood cell count: Symptoms, diet, and lifestyle changes. (2022, January 26). Www.medicalnewstoday.com. Retrieved from https://www.medicalnewstoday.com/articles/319457#summary
  5. ‌Cleveland Clinic. (2021, July 23). White blood cells: What are they, normal ranges, role & function. Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/body/21871-white-blood-cells
  6. ‌Horn, P. L., Pyne, D. B., Hopkins, W. G., & Barnes, C. J. (2010). Lower white blood cell counts in elite athletes training for highly aerobic sports. European Journal of Applied Physiology, 110(5), 925–932. Retrieved from https://doi.org/10.1007/s00421-010-1573-9
  7. ‌MS, J. W. (n.d.). Donating Blood and Exercise: What Athletes Should Know. Blog.nasm.org. Retrieved from https://blog.nasm.org/fitness/donating-blood-and-exercise-what-athletes-should-know
  8. Yeager, S. (2019, September 24). Need More Iron? When You Consume It Matters. Runner’s World; Runner’s World. Retrieved from https://www.runnersworld.com/news/a29176511/iron-levels-absorption-workout-timing-study/
  9. ‌TIBC (Total Iron-Binding Capacity) Test. (2023, May 11). Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diagnostics/24979-total-iron-binding-capacity-tibc
  10. ​​Latunde-Dada, G. O. (2012). Iron metabolism in athletes – achieving a gold standard. European Journal of Haematology, 90(1), 10–15. https://doi.org/10.1111/ejh.12026
  11. ‌Lee, E. C., Fragala, M. S., Kavouras, S. A., Queen, R. M., Pryor, J. L., & Casa, D. J. (2017). Biomarkers in Sports and Exercise: Tracking Health, Performance, and Recovery in Athletes. Journal of Strength and Conditioning Research, 31(10), 2920–2937. Retrieved from https://doi.org/10.1519/JSC.0000000000002122
  12. ‌de la Puente Yagüe, M., Collado Yurrita, L., Ciudad Cabañas, M. J., & Cuadrado Cenzual, M. A. (2020). Role of Vitamin D in Athletes and Their Performance: Current Concepts and New Trends. Nutrients, 12(2), 579. Retrieved from https://doi.org/10.3390/nu12020579
  13. ‌Lee, E. C., Fragala, M. S., Kavouras, S. A., Queen, R. M., Pryor, J. L., & Casa, D. J. (2017). Biomarkers in Sports and Exercise: Tracking Health, Performance, and Recovery in Athletes. Journal of Strength and Conditioning Research, 31(10), 2920–2937. Retrieved from https://doi.org/10.1519/JSC.0000000000002122
  14. ‌The Crucial Role of Hormones in Athletic Performance – Sports Medicine Weekly By Dr. Brian Cole. (n.d.). Dr. Brian J. Cole. Retrieved from https://www.briancolemd.com/blog-post/blog/the-crucial-role-of-hormones-in-athletic-performance/

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  1. https://www.thoughtco.com/red-blood-cells-373487