A New Paradigm for Performance Testing – Part 1
Written on April 21, 2010 at 5:20 am, by Eric Cressey
Last September, I was put in touch with Dr. Rick Cohen, and we hit it off right away. In addition to being a knowledgeable and super-qualified physician, Rick is also a baseball fan and performance geek just like me (I knew he was legit when I met him for the first time and he was rocking some Vibram Five Fingers shoes!). Rick’s enthusiasm and forward-thinking mindset is absolutely contagious and has gotten his company, Bioletics, off to a great start.
Just to get a feel for what he does (and while remaining unbiased), I had my fiancee go through a series of performance testing they do (outlined below) and the entire process was fantastic. One of the glaring issues discovered was low vitamin D, which has since been addressed. Just two months prior to our work with Rick, I’d encouraged her to ask her primary care physician to check her vitamin D levels at a routine physical. The physician’s response was “No. You’re not post-menopausal.” The take-home message from this quick story is that not all physicians have all the information (or even a small fraction of the information, as Vitamin D plays countless roles in the body other than bone metabolism).
Since forward-thinking physicians are few and far between, it’s sometimes a challenge to find someone good in your area – and that’s where a guy like Rick and his company can come in to help out. I highly recommend Bioletics – to the point that I wanted to get Rick on-board for an interview to share some of his great information. So, without further ado, Dr. Rick Cohen.
EC: Thanks for taking the time for an interview, Dr. Cohen. Please fill us in a bit about your background, what you’re doing at Bioletics, and where the idea for the business really emerged.
RC: My pleasure.
It actually all started in your neck of the woods in Massachusetts. I had a medical practice with a focus on nutrition, athletic performance and aging there for over ten years. At the time, I was very dissatisfied with the assessment options available in the medical field. So, I developed a few of my own that could be done at-home with either a saliva or urine sample or a finger stick blood spot.
After moving to Bend, Oregon last year, I became involved in screening some of the girls on my daughter’s track team for iron deficiency and bone health. We also looked at vitamin D, which is a critical nutrient for both bone health and overall athletic performance.
When the results came in, it turned out that 95% of the runners low in iron. Additionally, 80% of the team was vitamin D deficient and more than 50% were mineral imbalanced. After adding amino acid and recovery hormone panels to the screen, I repeated it with several local elite athletes. Again, the results were shocking: not a single athlete was healthy from a biological standpoint.
At this point, it was pretty obvious that there was a need to turn the entire concept of human performance testing inside-out. For years we’ve been obsessed with peripheral performance measurements-heart rates, VO2 levels and power output. But the idea of looking inside an athlete’s body has been completely overlooked.
Giving athletes the ability to assess their unique, physiological needs represents a paradigm shift in athletic performance. Despite all the marketing hype in the sports supplement industry, there’s no such thing as a one-size-fits-all formula for improving your athletic performance.
As athletes, our basic, biological needs are all very different. We would never think of buying a bike, a baseball bat, or a pair of running shoes without trying them on or out for size. Why do we use nutritional supplements-protein powders, recovery drinks and vitamins-without knowing if they are a good fit for us?
EC: Now, let’s talk about some of the specific things you guys can test. I’ve been a big vitamin D guy for years now, and I know that’s one of your core tests. What are you seeing thus far?
RC: Optimizing your level of vitamin D3 is the single most important thing you can do for your health and well-being-and quite possibly your performance. Interestingly enough, vitamin D isn’t really a vitamin at all. It’s a hormone manufactured by your skin during critical periods of sun exposure.
Vitamin D is both a key building block and a cellular activator of almost every physical process. It regulates more than 2,000 of the 30,000 human genes. It’s an essential part of the endocrine system, as it controls several of the adrenal hormones, growth of cells, and production of enzymes. It’s a powerful immune booster that provides a front-line defense against colds and flu as well as cancer and autoimmune disease.
Vitamin D is essential for optimum athletic performance, as it contributes to muscular strength and recovery while controlling physical reaction time, balance and coordination.
So far, almost every athlete we have tested has had sub-optimal levels of vitamin D (less than 50 ng/ml) except for one professional triathlete who trains in the sun in Australia all year. Many athletes have been extremely low-under 25ng/ml.
Unless you can train outside year-round and/or make a conscious effort to get mid-day sun exposure; it is almost impossible to restore vitamin D to an optimal level-between 60 and 80 ng/ml-without supplementation. When supplementing, the best results have come from the use of a sublingual vitamin D3 spray. Gel caps, tablets and liquids are less effective.
The most important thing to remember is that your vitamin D level needs to be assessed and monitored. You can’t just take a random dose of vitamin D3 and expect to get results. Bioletics offers an at-home finger stick assessment that is virtually pain-free; it takes only two minutes and two drops of blood to complete.
EC: Now, how about iron? It’s traditionally been a huge issue for female endurance athletes, but are you seeing it as much in females who aren’t on that level of training volume?
RC: Yes. We learned this is a huge issue, especially among teenage girls. In general, low iron is a problem among menstruating women because they lose blood every month. With teenage girls, the issue is compounded by the fact that their diets tend to be lower in calories, red meat and protein-all of which are critical for obtaining adequate iron.
Iron is critical for athletic performance, as it carries oxygen in the red blood cells from the lungs to the muscles. Severe iron loss results in a reduction of red blood cells (a condition known as anemia). What most athletes are not aware of is that you do not have to be anemic to be suffering from low iron. The most common signs of iron deficiency are fatigue, irritability, poor performance and slow recovery.
Another important point to stress is that while the assessment of red blood cell count, hemoglobin, hematocrit and serum iron are needed to diagnose anemia, these are not sensitive indicators when it comes to assessing deficiencies in iron stores-the supply of iron that’s actually available for the body to use. The iron-binding protein, ferritin, is a much more reliable marker of functional iron stores. We like to see levels of ferritin in females between 40 and 70 ng/ml.
EC: How about men? Is too much iron a common finding?
RC: Good question.
In men, we are much more concerned with excessive iron than with low iron. This is because men do not bleed regularly and also tend to eat more red meat and calories than women.
The problem with too much iron is that it can create free radical damage in the body. Just as iron in metal rusts, it has a similar action in your body. Fortunately, your body has natural antioxidants to protect against the free radicals created by iron. But when levels get too high, it can become a problem. As we get older, excessive iron levels can play a role in the development of heart disease, cancer and immune disorders.
Excessive iron is linked to a genetic variation in iron absorption rates. Hemochromatosis is a genetic disorder where the body absorbs iron too readily and iron stores can get tens or even hundreds of times higher than normal and cause severe organ damage. While the full blown disorder is relatively rare, many people have lesser variants which cause gradual accumulation of iron over time. The second cause is dietary-we take in too much iron by eating iron-fortified foods like breakfast cereals and breads.
Just as with vitamin D, it is necessary to know your iron levels before you begin to take any kind of iron supplement. The restorative dose of iron is generally 36mg daily while the maintenance dose for those with a history of low iron is 18mg daily. Taking a restorative dose without knowing a benchmark can push iron levels too high. Playing it safe and taking a maintenance dose may not be enough.
Ideal levels of ferritin in men are between 70 and 100 ng/ml. If your levels are higher than that, it is important NOT to take any iron supplements or eat iron-fortified foods.
We have seen iron levels in the upper 100s and low 200s in younger male athletes. For these men, we recommended they monitor the levels every few years and to consider donating blood twice a year. This will not only keep their iron levels from climbing, but will greatly help those in need.
Part 2 of this interview with Rick will run tomorrow, but in the meantime, I’ve asked with Rick to arrange for a special discount for EricCressey.com readers only. If you head over to www.Bioletics.com and enter the coupon code ECCPP25 at checkout, you’ll receive $25 off the cost of your initial basic or complete panel.
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