Tired? Over-training? Or RED-s
Its not normal to be tired all. The. Time.
Its not normal to feel like your legs are made of lead every time you climb the stairs.
Its not normal to wake up tired every day.
How do we know what is tiredness from a busy schedule and a period of life stress and when it’s something more serious?
Let me introduce you to Relative Energy Deficiency in sport a.k.a RED-s. At its top level, RED-s is insufficient energy intake and/or excess caloric expenditure [1]. It has been adapted from the previously known condition called the Female Athlete Triad.
The Female Athlete Triad is a relationship between menstrual irregularities or absence, low energy availability (with or without an eating disorder) and decreased bone mineral density [2]. The reality is that you won’t know if your bone density has decreased if it isn’t being monitored but it can be a fair assumption that your bone integrity is changing if you are repeatedly reporting stress fractures, increased bone breakage or your bone related injuries are taking longer to heal than assumed.
Unless you have a sports coach or a team nutritionist, you’re unlikely to completely nail your fuelling strategy whether you are a pro or you are a fanatic. Fuelling is hard. As a woman, you’ll burn approximately 100kcals per mile you run. How do you know how much to refuel with to support your training goals? Are you training to lose weight? Training for a race? Training to lift heavier? Training for life? How do you know how much is too much or not enough to eat?
If your food obsessed and unable to concentrate on anything other than food, what your next meal or snack is going to be, when you might get to eat it, perhaps how many calories its going o be - you may not be eating enough. This is the same if you are always cold and notice you’re wearing more layers than everyone else. If you’ve taken nutrition advice from a PT and they’ve told you to eat 1200 calories constantly - this also isn’t enough and you’re at serious risk of throwing your hormones out of whack and losing your cycle.
If you want to progress in your training, your basal metabolic rate should be the absolute minimum number of calories you are eating.
So what are my RED-s warning signs?
Fatigue is a real one. Not that ‘ooh I’m tired, I’ll go and have a nap’ tiredness but that ‘I’m genuinely too tired to wash my hair/cook dinner/put clothes in the washing machine/ walk around the block’ kind of fatigue.
We all know what it feels like to be a little bit tired, check in with yourself if you’re feeling consistently fatigued. When was the last time you didn’t feel fatigued? Will I feel better if I cancel my social plans this week and focus on some hard core self-care and early nights?
If you don’t know that last time you felt like you had energy or if a quiet week isn’t making a difference to how you’re feeling, its really worth checking in with your GP and getting a blood test to check for potential deficiencies - iron & vitamin D deficiencies also have fatigue as a presenting symptom - and consider working with a nutrition professional or a performance specialist to truly help you understand your energy and fuelling needs.
A niggling cold that takes an unbelievably long time to recover from or one cold that turns into another cold and another and then its a chest infection and a course of antibiotics. This also suggests that your immune system is compromised and your body is needing to divert forces to other vital processes in the body.
That’s why menstrual irregularity and absence happens. Whether reproduction is our goal or not, the female body’s purpose is reproduction. So, if our body’s are experiencing stress - insufficient fuelling and impaired recover - then your ovaries are sent a signal that now is not the ideal time to bare a child and the energy that would support a regular menstrual cycle is diverted elsewhere to maintain balance elsewhere in the body. Body processes like digestion and detoxification are far more important than your menstrual cycle. If your period is missing - although perhaps convenient - this is not how your body is designed to work.
Even a slower digestion, increased bloating and new IBS symptoms resembling IBS can be indicative of RED-s.
Recovery from RED-s is far more serious than regulating your period and fuelling sufficiently. As soon as you start to notice any of these warning signs, its time to reach out. I can help you, your sports coaches can help you and your healthcare professionals can help you. If something feels wrong and your period is missing or irregular, don’t take no for an answer. If your GP tries to send you away to come back in a couple of months to wait and see what happens, take action, take control.
You know your body and don’t let anyone else tell you otherwise.
