Blood Work for Athletic Performance

Post race winners and super elites aren’t the only ones getting athlete blood work testing. Now it’s used to check for so much more than doping! It’s a TOOL to help us improve our health and fitness.

Many endurance athletes, especially nerdy one’s like myself and Ben Greenfield, routinely run their blood work as part of ongoing pre-hab!

Just as I talk frequently about adding hip exercises and stretches to your routine to prevent injury, a little blood workup might prevent other training issues.

Intrigued? Wondering how to take advantage?

Performance Blood Testing

The first option is always to get a blood panel at a your yearly physical.

The upside is that this should be included for free with most insurance plans.

The downside is they likely won’t run all the things you need to know as an athlete and won’t provide you with detailed food or lifestyle recommendations on how to resolve any issues or potential issues. Unfortunately, their focus isn’t on the athletic population.

I mean only 1% of the US has run a marathon, so when they look at your levels, the normal range is based on who they’re testing you against…not your athletic peers.

And isn’t a potential issue really what you want to pay attention to?? Which means, if you can invest in an athlete blood testing, you’re likely to get a great deal more out of the results.

Let’s look at the one I recommend to our athletes!

This is my 10th straight year of testing with InsideTracker, so I’ve updated the post with more insights and tips that I’ve learned over the last few years of testing.

InsideTracker Review

InsideTracker, a blood test for athletic performance, reached out to me in 2015 with an opportunity to try their system. As noted, I’m a total geek for learning anything and everything I can about how my body is performing, so I jumped at the chance (and as noted have now done it consistently each year).

Personally, I want to know that what I’m doing is working for my body and if there’s a test that I can do once in awhile to keep things on track and ensure I’m running til I’m 90 then sign me up.

What can a blood test for runners tell you?

• High or low levels based on athletic lifestyle – again comparing you to people similar, not the general population
• Hormone deficits that might be from over training or nutrition – examples are high cortisol or high inflammation markers
• Nutrient deficiencies that you can fix with food – improving energy levels and performance
• Potential immune system issues – an over worked body is bound to get sick
• Are you over training (inflammation signals from certain levels will help identify this)
• DNA – a cool new feature that’s available to show your strengths or areas to be aware

How does InsideTracker work?

• Order the test online from InsideTracker  –Code RUNTOTHEFINISH gets you 20% off
• Get a list of nearby labs where you can get your blood drawn
• Go to a lab where they draw your blood and they send it off
• Wait for an email saying “WOHOOO Your Results are In”
• Log in to InsideTracker for an insanely detailed map of what’s green, yellow and red in your results (see examples below)
• Review the recommended foods or supplements to help address your issues
• Keep reading the great blog posts they send on sports nutrition

Based on your results you’ll get recommendations to improve:

• sleep
• boost energy
• reduce injury
• prevent illness
• generally enhance your performance

Ever wondered why you ALWAYS get sick the week of race, this might help you put an end to that. Finding out that you’re deprived of B12 or Vitamin D gives you something specific to take action on and support your body.

Checkout this chart on the Vitamins Athletes Need for Optimal Performance >>

Which InsideTracker Test Should You do?

A number of folks have asked me this question and of course it depends on your goals, but I would look at this way…

• If you are getting your annual bloodwork from the Dr, then you could do just the High Performance test.
• If you can’t get your Dr to do bloodwork you could do just the Essentials to check on your overall health.
• But if you are looking for health and performance, do the Ultimate Package the first time around. This will ensure you get the  most comprehensive results and know exactly what areas you need to pay attention to or maybe find out you’re a perfect specimen.
• Following tests or each year, you might be able to do just the Vitality or High Performance because you have a few areas that are more important to pay attention to than others.
• If you are doing multiple tests per year, then I definitely think one should be Ultimate and then the others can be smaller check-ins.
• I would de-prioritize DNA and InnerAge – they are cool, but if I had to pick where to spend money I’d start with the focused athlete blood work first.

Using Your Athlete Blood Test Results

In trying to give you a better idea of how the results work, I’m going to share some of my data from the Ultimate Package.

What runners need to know about Iron

Since low Iron is a problem for many athletes, who often don’t even know it, I thought I’d dive in to my own low results and what it means.

First they don’t just measure iron, they do the whole spectrum of Ferritin, hemoglobin, Iron, TIBC, and TS.

It’s important to realize they all work together and not in isolation.

Oxygen-carrying capacity of the blood is essential for endurance exercise as well as for normal function of the nervous, behavioral, and immune systems. Low iron is a common nutritional issue…Iron-deficient athletes have lower levels of red blood cells and hemoglobin, which may reduce oxygen delivery to the muscles and impact performance.

When one nutrient area is out of whack it can actually trigger a host of other issues and then cause more areas to be low or high. Again one of the main reasons for doing this kind of testing!

As noted below my levels were “very low”, which at first I blamed on not eating red meat…but then I thought about the mounts of spinach I eat and wondered how this could be.

Even meat eaters often have LOW iron during heavy training!

Read this post on tips for fixing iron deficiency.Luckily, InsideTracker provided a great article all about athletes and iron, along with articles that help to back up their recommendations. Here is a good breakdown on iron from Breaking Muscle:

Optimal levels of hemoglobin improve strength, increase endurance, and enhance overall aerobic performance. The amount of hemoglobin in your blood depends partly on the amount of iron stored by another biomarker, ferritin.

If ferritin is low, you have less hemoglobin and fewer red blood cells to carry oxygen. When your iron is low, you feel fatigued, workouts that were good standbys become demanding, and performance falters.

NOTE: This is KEY difference with InsideTracker reports; many times the range of “normal” is HUGE, but optimal is a whole different thing and that’s what you’re finding out here.

2020: I did a consult with one of their Registered Dietitians this time and agreed I would start adding in a super low dose Iron supplement because I have stayed just a little low in this year after year.

DO NOT supplement iron without getting bloodwork done! Having too much iron is not good for you.

Low VITAMIN D – Yup Even in Runners

I was also low in Vitamin D, which is amusing for someone who is outside non-stop, but turns out that nearly 50% of the US is low in Vitamin D. So even though we may be out running, depending on what we’re wearing (including sunscreen), time of day and other factors, it may not be getting used by our body.

Issues from low vitamin D for athletes:

• Fatigue
• Decreased recovery
• Bone loss
• Depression
• Muscle pain

I was low on my first test, so I started taking a Vitamin D supplement and then finally by my 2017 test my numbers were up…so you can guess I stopped taking it.

Now I’m just hanging on the edge of optimal.

Having also just met with my OBGYN, she wants me to get back on a supplement to make sure my bones stay healthy with my low estrogen levels. It doesn’t look like I’ll be over doing anything to add that in, so I’m happy to do it!

Athlete CORTISOL Levels

We’ve talked a lot about the role cortisol plays in weight gain and how our workouts can often add more stress to our lives. BUT we can use that stress to optimize things if we know how to do it right!

I knew this one would be high, it’s been high for years now. In part this is due to my non-existant estrogen levels, but it’s also due to training and my personality.

I am a thinker. I am a planner. I am a doer.

No idea why it matters if your cortisol is high? Well here are a few:

• Increases fat storage around abdomen (ugh)
• Accelerates aging
• Slows metabolism
• Weakens immune system
• One two punch on your mood

I appreciate that their recommendations focus on lifestyle {i.e. sleep, yoga, reduced training, creative outlets} and foods that can help.

They also point out all the ways it’s going to impact performance, so if you can’t make a change for your health maybe you’ll do it to run faster!

2018-2020: Good news, all the lifestyle things I’ve put in to place finally has this number working for me. The biggest factor is sticking to LHR training. That for me keeps my cortisol down my hormones happy.

What else is in an InsideTracker Test?

• Blood glucose levels – sees how your body is processing sugar
• Cholesterol levels – gotta keep the heart happy
• B vitamins, Magnesium, Folate
• Potassium, Sodium
• Testosterone, DHEA
• Variety of Liver enzymes
• CReactive Protein and white blood cell count – an inflammation marker

Optimum Blood Test Results

Listen the goal isn’t just to get back a perfect report card, it’s to feel better. Hopefully that means we can keep running and enjoying hitting new goals, even as we age!

Over the years I’ve done a few different things to optimize my levels and here are a few:

• Daily Probiotic – Gut health is huge for athletes, find out which probiotics are best
• Pumpkin seeds and raisins for helping iron deficiency as a runner
• A little red meat every few weeks for iron and B12
• Checkout my post on trying B12 shots – this was something I needed early on because it turns out I wasn’t eating nearly as much protein as I thought.

And I’d like to point out that my Calcium is spot on even though I’m mostly dairy free!! (Should you go dairy free?)

There is so much more information here, but now you have an overview of just what you can learn from performance blood testing. It really is about better health, which results in better training…and tada better racing.

Find out more about InsideTracker and I highly recommend reading their blog.

Would you ever do a blood test for athletic reasons?

Have you ever made changes based on blood work and felt better?

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This time I truly bled for my work. I received a test for free in exchange for an honest review, which you have received!