You probably would need a pre-race baseline to compare to if this is going to be in any way useful.

I would be curious to see C reactive protein levels.

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Brian

If this piqued anyone's interest here is an article that briefly summarizes some of the biochemical responses to prolonged, strenuous exercise-- http://bjsm.bmj.com/content/36/4/301.full. A bit brief, but it references a bunch of more in depth papers if you want to read them.

I know you probably aren't going to do it, but I would love to see you get an Echo on your heart and test the EF (Ejection Fraction)

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I am also curious about your HDL and LDL cholesterol levels. After Kona 2005, Simon Lessing said his values were through the roof and then things normalized.
Also HCT and Iron levels before and after (if any changes) would be interesting.

Quest is as good as any for these basic studies
get a complete metabolic panel for completeness.
also track done your most recent baseline labs

AST levels in liver?

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http://www.sfuelsgolonger.com

Hello all, My name is Dr. Garret Rock. I work for Phuel Sports Science, whose new public offering is AthleteBloodTest.com. I have been intimately involved in research on using blood biomarkers in athletes for 8 years. I also personally work with thousands of professional athletes and 4 national governing bodies of sport (Olympic teams), including pro triathletes, runners, cyclists, and hockey teams. I may be able to help you determine which tests are ideal for your analysis.

Blood tests are extremely useful following (and prior to) big race efforts. Through a blood test, and interpretation by an expert trained in working with athletes, we can determine

• how your unique physiology tolerates/responds to the stress of the effort you put forth
• ideal recovery methods and recovery time needed based on muscle breakdown markers and hormone response to your race effort, and
• micronutrient utilization rates, which will help determine the ideal recovery diet/nutrition strategy for recovery and future race prep
• much more, but for the sake of this conversation

You will need more than a CBC, CK, and Testosterone to accurately determine the above. Following the effort you went through, in order to gain knowledge that can help you in the future, I recommend a more comprehensive panel. As an example of why, testing testosterone will give you a snapshot of where it is at now. However, by also including DHEA-S and Sex Hormone Binding Globulin we can gain a better understanding of the effect your race effort had on testosterone levels. This will help you determine things such as what the ideal taper period is for you, what the ideal training volume is for you (recovering from efforts is nearly as important as the efforts themselves), and what the ideal recovery time following a race is for you. There are many more scenarios behind every test I recommend below. I don't have time to write them all.

It is also critical to test micronutrients. Micronutrient utilization rates vary for each individual. Not all athletes need iron supplements (should never be taken blindly). Some absolutely do after they exceed a certain training volume per week. The only way to know your unique needs, which will help you construct the ideal nutrition strategy throughout your training and racing season, is to get blood tests.

Below is the panel I recommend:

Complete blood count with differential
Comprehensive Metabolic panel
Reticulocytes
Iron, serum
Ferritin
B12
Folate, serum
Magnesium
Vitamin D, 25-OH
Cortisol
Thyroid Stimulating Hormone
Sex Hormone Binding Globulin
DHEA-S
Testosterone, free
Testosterone, total

Last words of advice. Don't try to interpret yourself. I have seen tens of thousands of tests on athletes now and analyzed a giant database that we've been populating over the last 4 years, as well as read thousands of studies...and I am still learning something new occasionally. To get the most out of your tests, rely on those that have a comprehensive understanding of how to tie all of the information together. It's much more complex than simply looking at a number and comparing to normal/abnormal range. Ideal ranges and normal ranges vary based on your age, gender, and frequency/duration/intensity of training/racing. These should be factored in to your interpretation.

I surely do not mean to advertise a service I am involved in on this forum, but it does provide a solution for anyone interested in what you are posting about. It also prevents the mistake of doing it yourself or through somebody untrained in athlete biomarkers. I invite you to use our service if you desire. We can be found at http://www.AthleteBloodTest.com.

We do require a coupon/access code currently as the service is a new public offering and we are largely working through coaches right now as we update the website.

Here is a coupon/access code, which also provides a little discount: 5offabt!

I hope the information I provided is helpful.

Thanks now that I see your name, it rings a bell; I believe Ivan O' Gorman actually recommended you to me.

Since you're local maybe I just pay you a visit. I'll send you an email

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Are you ready to do an Ultraman? | How I calculate Ironman race fueling | Strength Training for Athletes |

A team of Florida State University researchers studied some athletes at the 2015 Ultraman Florida...



http://www.sciencenewsline.com/...015111819470019.html

Troponin and Lactic Acid. Might be too late for these though.

I doubt Troponin is elevated (at least I sure hope there's no MI associated with an ultraman ;) . How about Myoglobin? However, the draw probably would be more interesting if taken right after the finish.

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Of course it hurts. The trick is not minding it hurts.

Doesn't have to be an MI to have an elevated tropnin. Exercise Induced Troponin Elevation is a real thing.

Hey Dr. Rock, looking at your blood tests they resemble what I usually get from Quest, so is it possible that our insurance could pay for them through you guys? Does that happen at all, folks having insurance pay you directly for the actual blood work?

I like what you are doing, something I have done with my doc the past 30+m years. I imagine you guys have a much wider data base and can work more with some of those little markers we tend to ignore in our blood tests. Read through your blog articles and they are intriguing.

cortisone

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

Also HbA1c. I understand endurance athletes in heavy training can get "pre-diabetic" readings. Similar "borderline" readings for total cholesterol due to very high HDL levels combined with normal LDL/triglycerides.

Ian

especially likely with my recent super-high carb load experiments...

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Are you ready to do an Ultraman? | How I calculate Ironman race fueling | Strength Training for Athletes |

Are you actually planning on doing this?

Every day that goes by makes it less and less likely that you'll see anything interesting.

I'm also skeptical of the conclusions that you could draw without having performed a pre-race baseline.

I've already done it. I agree about the baseline - I just was not able to get it done beforehand - plus my training load was super high so the baseline would also not have been in a "normal healthy" state. So I will get another baseline around Jan/Feb, which will at least give us some healthy values, even though it's after the fact not before

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Are you ready to do an Ultraman? | How I calculate Ironman race fueling | Strength Training for Athletes |

Hello Monty,

We are not able to order through insurance, as these are not related to symptoms of a health condition and are not considered standard "wellness" panels. We wish we could accommodate this frequent request. However, being insurance is not interested in how well you perform athletically they are not willing to pay for performance based testing. In addition, telemedicine is typically only covered in underserved or rural areas. So, even if you are experiencing symptoms warranting these tests, unless you live in a medically underserved area this is not an option. However, if your primary care doc can organize the testing, we do provide an analysis only option for $99.

Yes, our database is very large and entirely dedicated to athletes, broken down by age, gender, and frequency/duration/intensity of training. Our panels are based on over 8 years of research, to which we also researched which tests have a high benefit:cost ratio and which are insignificant or do not require testing for accurate conclusions (we even compared to intracellular and metabolite based tests). There is a purpose for every biomarker in our panels and over 80% of the biomarkers are cross-referenced to other biomarkers. For example, AST and ALT are cross-referenced with cortisol, testosterone, DHEA-S, SHBG, and glucose to determine whether those findings are indicative of excessive muscle "damage" (a sign of over-reaching/over-training, or delayed muscle recovery) or you simply release high amounts during workouts. These cross analyses and the specificity to your age, gender, and training regimen is why our service is trusted by so many pros and Olympians over cookie-cutter reporting systems.

It's healthy to be skeptical. However, you'd be surprised at the amount of information that can be gained with a post-race test, even without a baseline. A baseline test is always beneficial to work off of. When a post-race or post-big effort test is compared to a baseline we are able to identify micronutrient utilization rates (help determine an ideal diet for you and whether specific supplements are needed or not), recovery responses (help determine ideal taper plans and post-workout recovery needs), red blood cell destruction rates and recovery rates, muscle breakdown (can help determine ideal pacing and race distances), and more.

However, a big race effort is hard on the body. The tests that are quick to recover are the least important. In most cases, we do not even want to test until at least 5 days post-race, and up to 3 weeks post-race is valuable. Less than 5 days post-race gives too many false positives or false impressions. We want to see how the body is recovering, that is where the important information lies. By testing after the race the focus is primarily what needs to be done to recover physiology. In addition, we can gain decent insight into those concepts listed above. robgray has a good plan. Test now, perform a baseline later during the off-season and with the help of an expert he will have conclusions to the concepts in the paragraph above. This information is invaluable for athletes. You greatly reduce the risk of the performance zapping physiological "conditions" creeping up in the future.

Test for EPO, Cortisone and Steroids.

LOL, in case they were accidently ingested via supplements!

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<We all know that light travels faster than sound. That's why certain people appear bright until you hear them speak>

of course anyone who ever beats me should be tested for those

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Are you ready to do an Ultraman? | How I calculate Ironman race fueling | Strength Training for Athletes |