Relative Energy Deficiency in Sport (RED-S)

Relative Energy Deficiency in Sport (RED-S) is a condition that occurs when the energy intake of an athlete is not sufficient to support their training and performance needs. RED-S can affect athletes of all genders, ages, and levels of competition.

Causes of RED-S

The most common cause of RED-S is insufficient calorie intake.  This can occur due to disordered eating behaviors, weight loss diets, excessive exercise, and stress. In female athletes, menstrual dysfunction is a common symptom of RED-S, and may be caused by hormonal imbalances resulting from insufficient energy intake. In male athletes, RED-S can result in decreased testosterone levels, leading to reduced muscle mass, decreased bone density, and impaired athletic performance.

Symptoms of RED-S may include fatigue, reduced endurance, decreased strength, decreased coordination, and increased risk of injury. In female athletes, menstrual dysfunction, including irregular periods or the absence of periods, may also be present. In male athletes, symptoms may include a decrease in muscle mass, low libido, and erectile dysfunction.

Other common symptoms include:

1. Inadequate energy intake from food (this may or may not include eating disorders)
2. Imbalanced hormones (periods typically stop for a long time)
3. Poor bone health (osteopenia and osteoporosis)
4. Feeling cold all the time
5. Fatigue
6. Poor Sleep
7. Hair Loss
8. Splitting Nails
9. Dry Skin
10. Low Self Esteem
11. Depression and other Mental-Emotional Symptoms

In both sexes, symptoms of RED-S can also include mental emotional symptoms as well. These include irritability, depression, impaired judgment, and decreased coordination and concentration, among others.  

Diagnosis of RED-S
Is based on a combination of clinical symptoms, physical examination, and laboratory tests. Athletes who are at risk for RED-S should be monitored closely by a healthcare professional, who can assess energy intake, body composition, and hormone levels.

Treatment of RED-S 
Should be individualized, and may include changes in diet, reduction in exercise intensity or frequency, and psychological counseling. In some cases, medication may be needed to restore hormone levels or treat medical complications resulting from RED-S.

As these aspects are covered, we recommend starting with some foundational nutrient support with the following: 

• Osteo Formula contains all of the nutrients needed to restore and maintain bone health.
  
• Vitamin D is essential for bone and immune system health. It helps the body absorb calcium, and directly supports the immune system.
• Pure Omega-3 Fish Oil provides 2 grams of the important omega-3 fats which support brain and hormonal health.
  
• Ligament Restore will assist repair and strengthen tendons and ligaments that can become weakened from hormonal imbalances.

Prevention of RED-S 
Is key, and requires a comprehensive approach that includes education, monitoring, and support from healthcare professionals, coaches, and teammates. Athletes should be encouraged to maintain a healthy, balanced diet that meets their energy needs, and to avoid fad diets or restrictive eating patterns. Athletes should also be educated on the importance of adequate rest and recovery, and on strategies to manage stress.

RED-S is a serious condition that can affect athletes of all genders, ages, and levels of competition. It is important for athletes, coaches, and healthcare professionals to be aware of the signs and symptoms of RED-S, and to work together to prevent, diagnose, and treat this condition. By promoting a healthy, balanced approach to training and nutrition, athletes can optimize their performance, while reducing their risk of developing RED-S and other health complications.