Those who weigh less are more successful in sports. This supposed formula for success can have devastating consequences for athletes: suffering from RED-S syndrome. A new method could soon make it possible to reliably diagnose the threatening syndrome – and thus save lives.
By Hajo Seppelt and Lea Löffler
Anja Kern loves the triathlon. For a long time she tried everything to be successful as an amateur. Also, being light and thin like her role models was a goal she aspired to. Anja Kern did not associate the numerous injuries, constant fatigue and infections that were occurring more and more frequently with her training and diet. She found no answers to her problems from doctors. She says: “In the end I was so tired, exhausted and sick that I really had concrete thoughts of suicide.”
Study should enable early detection of RED-S
The reason: Anja Kern suffered from RED-S syndrome, the relative energy deficit in sport. She hadn’t eaten enough in relation to her training volume, her body was in a permanent exceptional situation. Other consequences of RED-S can be: depression, stunted growth, broken bones, serious hormonal problems such as missed periods in women or reduced sex drive in men. Experts estimate that around 20 to 30 percent of all athletes are affected by the syndrome.
Since RED-S is still largely unknown among doctors and there is still no clear diagnosis, the path to treatment can often be painful and long for those affected. A problem that researchers at the German Sport University Cologne now want to combat. In a study, they are testing a diagnostic method that should make it possible to detect RED-S at an early stage – without having to go through years of medical marathons.
“Many affected people who are not aware of the problem”
Around sixty men and women are taking part in the study to develop the method. The ARD doping editorial team accompanies two women at the start of the study. At the beginning, the subjects are examined and basic data is recorded: weight, size, proportion of muscle mass and fat in the body, as well as calorie consumption in resting phases.
A questionnaire then addresses nutrition and injury history. In order to be able to reliably assess the risk of RED-S, a comprehensive examination of the athletes is necessary. Test person Sarah Valder is taking part in the study to help make the syndrome more tangible, better known and ultimately also easier to treat: “There are many people affected who are not aware of their problem.”
Hormonmessung per Fingerpieks
During the six-month analysis period, a newly developed tool is used to take capillary blood from the fingertips. Women take the blood at a certain point in their cycle, for men it is necessary to send in capillary blood every 30 days.
The special feature: The blood collection device, which looks similar to a corona test, can be sent by post. A newly developed pad that absorbs the blood can conserve it longer. Ten different hormones are then examined in the blood in the laboratory. Together with a prepared diet and exercise log and the measurements in the institute, a reliable statement should be made at the end of the study as to whether the respective test person is affected by RED-S – at least that is the goal.
From the laboratory to the sports field
The study will run until 2024. With the new method, RED-S could be diagnosed in a few months in the future, while those affected have been groping in the dark for years. To ensure that the help arrives, Chiara Tuma, head of the study, believes it is important to build a bridge to organized sport: “Of course, our goal is also to transfer research into practice and then to use this tool in practice, in associations, in clubs, at athletes themselves.”
The formerly affected triathlete Anja Kern thinks that such a diagnostic method would have helped her decisively. “That would have saved me a lot for maybe ten years,” says Kern. In the meantime, she has brought sport and nutrition into line and is healthy despite a high level of training. She is hopeful that there could soon be a standardized RED-S diagnosis for women and men.