Sports Medicine

Internal Medicine for Athletes

"Optimizing health and performance for athletes"

We specialize in treating athletes, going above and beyond typical medical care and using everything modern medicine has to offer to optimize health and athletic performance.

We see professional and amateur athletes in the Denver area and from overseas. We are aware of U.S. Anti-Doping Agency (USADA) and World Anti-Doping Agency (WADA) rules. We know what can be used both in and out of competition.

Athletes are often under-served in medicine because doctors assume there is nothing wrong with someone "so healthy." However, athletes have very different metabolic and nutritional needs compared to the general population and are keen to notice when something isn't right.

The term "internal medicine for athletes" refers to the fact that we look beyond just treating sports injuries. Typically athletes come to us either because their athletic performance is slipping or becasue they want to perform even better and start getting to the podium.

How we can help

Fatigue and energy problems: Overtraining syndrome, malnutrition, adrenal burnout, hormone imbalances and various nutritional deficiencies are common. Thyroid disorders are also fairly common. Both testosterone and thyroid hormone can help performance by increasing injection fraction (heart function). Looking at testosterone in relation to cortisol can help determine an anabolic/catabolic imbalance.

Among older men it may help to replace the decline in testosterone, which can negatively affect body composition and physical function. As men age cortisol tends to increase. Cortisol is the only hormone that increases with age.

Studies have shown that endurance-trained men tend to have lower levels of testosterone compared to sedentary men and that men who weight-lift have higher basal testosterone levels. Studies have found that both endurance and resistance-trained men had lower testosterone levels than sedentary control subjects. We have found a similer situation with women.

In women, estrogen can be depressed leading to disruptions in the menstrual cycle and resultant decrease in bone mass. Women may be more dependent on growth hormone for anabolic gains than testosterone. Women whose energy expenditure exceeds dietary energy intake are at risk for GnRH suppression leading to hypoestrogenism. Treatment with estrogen and dietary counseling can fix this problem.

Sports anemia: This is different than regular iron deficiency anemia and is defined as suboptimal iron stores affecting red blood cell production and hemoglobin levels. Think of it as pre-anemia. Often it can affect performance. Intravenous iron can correct this very quickly.

Exercise performance enhancement: The best thing for our mile high athletes is supplemental oxygen, intravenous antioxidant and vitamin cocktails, and intravenous iron (if needed). Supplemental oxygen allows you to train as if you were at sea level while still getting the benefits of living at altitude. Intravenous iron can also be very helpful if iron stores are low. We stay up-to-date on the latest science regarding nutritional supplements and will discuss evidence-based options.

Fractures: Stress fractures often have an underlying cause such as low estrogen, vitamin D deficiency or mineral deficiencies (calcium, magnesium, silica).

Poor recovery: This is usually caused by hormone imbalances, overtraining or nutritional deficiencies. Occasionally low antioxidant levels in the body can increase the prevalence of muscle pain. New research on vitamin D indicates it may help with this condition.

Exercise-induced asthma: This is a very treatable condition. Intravenous magnesium is very helpful. Magnesium acts as a bronchodilator and makes the airway less reactive.Studies: Intravenous magnesium sulfate treatment for acute asthma in the emergency department: a systematic review of the literature. Ann Emerg Med. 2000;36:181-190.

Intravenous magnesium as an adjuvant in acute bronchospasm: a meta-analysis. Ann Emerg Med. 2000;36:191-197. 

Gastrointestinal problems: Parasites, food allergies, fructose intolerance, gluten intolerance and malabsorption syndrome are common. Hospital labs typically miss parasites because they are difficult to detect unless a specialty lab is used. Giardia and blastocysytis hominis are common infections in our althlete population. Swimming in fresh water and third world travel is how most athletes get parasites. Poor digestion can lead to discomfort, fatigue and malnutrition is some cases.

Allergy: When allergies affect performace you need fast solutions. Stabilizing histamine release and lowering immune reactivity is critical. Often this can be achieved with natural medicine. If stronger solutions are needed, we stay up-to-date on natural and U.S. Anti-Doping Agency (USADA) approved prescription medications for effective allergy control.

Cold and flu prevention: This is critical because missing an important race or valuable training time is not acceptable to serious athletes. It's important to look at immune system function and correct hormone, mineral and vitamin imbalances. We have seen some good results with vitamin D recently.

Many athletes (and doctors) do not know about the benefits of vitamin D. If you are vitamin D deficient, the medical literature indicates that the right amount of vitamin D will make you faster, stronger, improve your balance and timing, etc. How much it will improve your athletic ability depends on how deficient you are to begin with.

To schedule an appointment call  303.884.7557.