Talking to Your Healthcare Team
As an athlete, your body is your most valuable asset, but getting the right medical support can sometimes be a challenge.
Whether you’re dealing with unexplained fatigue, stress fractures, or changes in performance, it’s critical to communicate effectively with your medical staff. However, through no fault of their own, many healthcare professionals aren’t trained to recognize the signs of REDs, which means you may need to take an active role in advocating for your health. By preparing for your medical appointments and knowing what to ask, you can ensure that your concerns are taken seriously and get the support you need to stay healthy and perform at your best.
Why Seeking Support Can Be Tricky
For female athletes, one major red flag for REDs is a missing or irregular menstrual cycle. If you’re using hormonal birth control, this is impossible to detect because contraceptives suppress your natural ovarian cycle. Unfortunately, while we wait for clinical practice to catch up with the research, many medical professionals still assume that hormonal birth control is an acceptable substitute for a natural cycle. It is not. Even if you’re not on birth control and have irregular periods, you might be told this is “normal for an athlete.” It is not!
Birth Control
Wondering which form of birth control could suit you best? Check out some advice, here.
Similarly, male athletes experiencing REDs-related symptoms, such as low libido, reduced muscle strength, or a lack of morning erections, may struggle to get their concerns taken seriously. So, no matter your gender, age, or situation, understanding your own health is essential.
Before Your Appointment: Setting Yourself Up for Success
If you are concerned about REDs, the first step is to speak with a healthcare professional who understands athletes and the condition. In the United States, REDs is typically best managed by a sports medicine physician with experience in REDs or sports endocrinology. Specialists such as sports dietitians and mental health professionals with athlete experience can also play an important role in your care.
Many athletes feel unsure about what to say in an appointment or worry they will not be taken seriously, especially if they “look healthy” or are still performing well. Preparing ahead of time can help you feel more confident and ensure your concerns are understood.
Here’s some advice on how to get the most out of your appointment and increase the likelihood of receiving the right support:
1. Prepare in Advance
Before your appointment, gather a concise overview of your health and training history, including:
Your typical training hours and intensity
A general idea of your nutrition habits and relationship with food
Any past illnesses or injuries (e.g. repetitive soft tissue injuries, or stress fractures)
Changes in energy levels, mood, or performance
A willingness to speak openly and honestly with the physician about how you are feeling, both physically and emotionally
Consider asking your coach, athletic trainer, or sports dietitian for their input on patterns they’ve noticed in your performance or recovery.
2. Bring Information with You
Since many medical professionals aren’t familiar with REDs, it helps to bring resources to your appointment. Consider printing a copy of the REDs Clinical Assessment Tool or a letter explaining the condition. If your provider seems uninterested in learning more, you may want to seek a second opinion.
3. Advocate for Further Testing
If you suspect REDs, it is reasonable (and important) to request medical testing to help build a clearer picture of your health. Bloodwork is often the most useful first step, because key markers such as T3, LDL cholesterol, and testosterone in males can change earlier in low energy availability. These results should always be interpreted by a clinician who understands REDs and the specific demands of athletes.
Bone scans, such as DXA, can be helpful in certain cases, especially when there is a history of stress fractures or bone-related injuries, but they are not always the first or most reliable indicator. Bone density can be influenced by genetics and by the type of sport you do, and changes often only show up after prolonged low energy availability.
The most important thing is that any testing is ordered and interpreted by a healthcare professional with experience working with REDs in athletes, so that results are viewed in the right context and an appropriate plan can be put in place.
4. Remember, Athletes Are Different
Standard medical reference ranges often don’t apply to athletes. For example:
Iron levels: Endurance athletes often need double the iron levels of non-athletes
Weight misconceptions: REDs is not limited to athletes with low body weight. It can affect anyone, regardless of body shape, weight, or size.
Blood tests: If your results are described as “within normal ranges” but you still have symptoms or concerns, it is okay to ask for a copy of your results and request further explanation. A sports-informed clinician can help interpret them in an athletic context.
5. Be Honest
To get the right help, you need to be open about your nutrition, training, and mindset around food and exercise. Ask yourself:
Am I unintentionally under-fueling?
Could I be unintentionally under-fueling?
Do I worry about eating too much or gaining weight?
Am I unsure if my intake supports my training load and hormone health?
Do I have concerns about disordered eating or compulsive exercise?
If any of these resonate with you, share them with your medical provider.
7. Trust Your Instincts
As an athlete, you’re used to pushing through challenges. But when it comes to your health, listening to your body is crucial. If something feels off, don’t dismiss it. If your first appointment doesn’t give you the answers you need, keep advocating for yourself.