Optimise your biomarkers for peak performance
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.
What we test
Female Hormone Panel
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.
The FAI is a calculated ratio used to estimate the amount of active, or 'free' testosterone in the bloodstream that is not bound to SHBG.
SHBG is a protein that binds tightly to testosterone and oestradiol. Changes in SHBG can affect the amount of hormone available for use by the body's tissues.
Insulin-like growth factor-1 (IGF-1)
IGF-1 is involved in a wide range of physiological processes, including bone growth, muscle growth and repair, and the development of the nervous system. It also helps regulate metabolism, including glucose metabolism and fat metabolism.
IGF-1 plays a role in maintaining tissue and organ function throughout adulthood. It helps regulate bone density, muscle mass, and cognitive function, and it has been implicated in the aging process.
Adrenocortex Function (serum)
Cortisol and DHEA-S play important roles in regulating physiological processes in the body. 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.
Thyroid Function
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.
Active Vitamin B12
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.
Active vitamin B12 is the biologically active form of vitamin B12 that is essential for many physiological processes in the body, including the production of red blood cells, DNA synthesis, and nerve function.
Ferritin (Iron Stores)
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.
Ferritin is a marker of iron stores in the body, and is used to assess iron status. Low levels can indicate iron deficiency, which is a common nutritional deficiency that can lead to anaemia, fatigue, and impaired immune function.
Bone Health
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.
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.
Calcium is important in building strong bones and teeth, but it also plays a key role in other functions including muscle contraction, nerve function, blood clotting, and enzyme function.
Corrected calcium adjusts for changes in serum albumin levels, providing a more accurate measure of the biologically active form of calcium, and is therefore a better reflection of the body's calcium status.
If too much urate is produced or not enough is excreted, it can accumulate and lead to gout – an inflammation that occurs in joints.
Phosphate is a mineral which is essential for the formation of bones and teeth. It is also essential for many other cellular processes including energy metabolism and the formation of DNA and RNA.
Magnesium and calcium work together closely to maintain strong bones, and magnesium deficiency has been associated with an increased risk of osteoporosis.
Cholesterol
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.
Total cholesterol includes both HDL cholesterol and LDL cholesterol. Cholesterol is essential for many processes in the body, including the formation of cell membranes, the production of hormones, and the metabolism of vitamin D.
LDL cholesterol is often referred to as "bad" cholesterol, as it can contribute to the development of atherosclerosis, a condition where plaque builds up in the arteries and can increase the risk of heart disease.
HDL cholesterol is often referred to as "good" cholesterol, as it helps remove excess cholesterol from the bloodstream and can protect against the development of heart disease.
Triglycerides are the main storage form of fatty acids in the body and a source of energy. High levels of triglycerides are associated with cardiovascular disease, obesity, type 2 diabetes, and metabolic syndrome.
Non-HDL cholesterol is considered an effective lipid measurement for assessing cardiovascular disease risk as it is believed to reflect levels of 'bad' cholesterol.
Metabolic
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-IR score is a calculation used to assess insulin resistance. A higher score indicates a greater degree of insulin resistance, and is associated with an increased risk of type 2 diabetes and cardiovascular disease.
HbA1c measures the average blood sugar level over the past 2-3 months. The higher the percentage, the higher the average blood sugar level has been over the past 2-3 months.
HbA1c can be expressed as a percentage (DCCT unit) or as a value in mmol/mol (IFCC unit).
Full blood count with differential
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.
MCV is a measure of the average size of the red blood cells. The MCV may be elevated in anaemia caused by vitamin B12 or folate deficiency. Whereas decreased MCV may be seen in iron deficiency anaemia for example.
MCH is a calculation of the average amount of oxygen-carrying haemoglobin inside a red blood cell. Large red blood cells tend to have a higher MCH, while small red cells would have a lower value.
MCHC is a calculation of the average concentration of haemoglobin inside a red cell. Decreased MCHC is seen in iron deficiency anaemia and conditions such as thalassaemia.
RDW is a calculation of the variation in the size of your red blood cells. A high RDW value may indicate the presence of certain medical conditions, such as anaemia, liver disease, or vitamin B12 or folate deficiency.
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.
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.
Basophils are a type of white blood cell. Basophils can increase in cases of leukaemia, long-standing inflammation and hypersensitivity to food.
Responsible for blood clotting and healing. A high count can indicate a risk of thrombosis, whilst a low count can lead to easy bruising.
Liver Function (LFTs)
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. Low levels can indicate malnutrition or other health problems.
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.
Any of a group of simple proteins found in the blood.
Kidney Function
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.
Sodium is important for maintaining fluid balance in the body and for proper nerve and muscle function.
Potassium is important for nerve and muscle function, including regulating heart rhythm, and is also involved in fluid balance.
Chloride is important for maintaining fluid balance and for the proper functioning of the digestive system.
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.
Pancreatic Function
Proteins, fats, and carbohydrates are broken down by stomach acids, enzymes produced by the pancreas, and bile from the liver. This process also releases micronutrients. This blood test measures the levels of enzymes produced by the pancreas.
An enzyme produced by the pancreas which is released into the digestive tract to help digest fatty foods.
An enzyme made mainly by the pancreas which is released from the pancreas into the digestive tract to help digest starch in our food.
Inflammation
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.
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
Erythrocyte Sedimentation Rate (ESR) is an indirect measure of the degree of inflammation present in the body. Increased blood levels of certain proteins (such as fibrinogen or immunoglobulins, which are increased in inflammation) increase the ESR.
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.
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.
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.
Test instructions
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.
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