Mountain and stream

Athletes: Things to Consider in Performance Optimization

Dr. Sasha Fluss ND at NatureMed Clinic Boulder/Denver


Boulder is the Mecca for endurance sports. We see a lot of athlets competing at all levels from professional to weekend warriors and in a wide variety of sports from triathalon to swimming to climbing to cycling. Once reason I love working with athletes is that optimizing performane and athletic capacity is really about optimizing health. It is about the little things that give you that extra push. Whether it be extra energy in the morning to get up and complete your workout or less fatigue running up those hills or better recovery from workouts and injury prevention. There is so much we can do when working with athletes looking to increase their fitness and performance at any level. Here are some things to consider and components I generally look at:

  • Iron levels: very important especially at altitude. Iron is what carries oxygen in the blood to our tissues and muscles so we are able to run up that mountain! Levels can be tested in the blood and optimal levels are much higher than what your doctor would call deficient. Optimal iron levels can be achieved via supplements, injections or IVs. Often injections or IV iron administration is preferred as iron levels can come up within days vs months and much higher levels can be achieved
    • Symptoms of low iron/anemia include: fatigue, easy bruising, muscle weakness, inability to perform at altitude, shortness of breath, hair loss, pale skin
  • Thyroid assessment: Your thyroid is your body’s metabolic control. Athletes need optimal levels of thyroid hormones to keep energy levels optimal. Levels and more indepth examination than routine thyroid testing can be run via blood testing.   Optimal levels can be assessed. 
    • Symptoms of hypothyroidism/low functioning thyroid gland are: fatigue, weight gain or inability to lose weight, dry skin, muscle weakness, edema and puffiness, hair loss etc.
  • B12 Levels: B vitamins are very important for energy production and are depleated by stress whether it be physical or psychological. Levels can be evaluated in the blood and are also based off of symptoms. 
  • Adrenal Fatigue: Many athletes have some level of adrenal fatigue especially if you are training at a high volume along with the stress of every day life. Both physical exertion and psycological stress drain out adrenal glands and can lead to adrenal fatigue. Most athletes have some level of adrenal fatigue from mild fatigue to adrenal exhaustion. Your adrenal glands are assessed via thurough history as well as sometimes salivary testing is indicated.
    • Symptoms of adrenal fatigue include: fatigue, exhaustion, exercise intolerance, insomnia, weight gain,  menstrual dysregulation, anxiety, depression etc.
  • Hormonal Balance: Estrogen, progesterone, testosterone and DHEA are finely balanced in relation to adrenal hormones and thyroid hormones. Making sure you have optimal levels of all hormones is essential to performance. At NatureMed we often go by symptoms to assess hormones balance and check testosterone levels via the blood. Hormones can also be assessed more accurately through the saliva and urine. 
  • Diet: What you eat, how you eat and when you eat can have a huge impact on your training efficacy and overall energy and wellbeing. For many athletes I create specific guidelines along with recipes and diet plans to make sure they are optimizing their nutrition and getting as many nutrients as they can from food sources.  

There are many things that contribute to you performing at your best. We will take a detailed look at all of these factors and more in your first office appointment.