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Testing Options for Athletes: The Proven, Unproven, and TBD

The wide world of sports is being inundated with physiology tests promising data to determine your unique physiological needs. From blood tests to genetic tests, saliva tests, and even hair analysis, the options seem to be expanding.

For this reason, we decided to grade each testing method based on research available. The Four Factors used in scoring include:

  1. Validity – is the data factually sound?
  2. Reliability – is the data consistently accurate?
  3. Is there research specific to athletes?
  4. Is there an option that is proven more valid and reliable?

Blood Testing

Grade: A

Blood testing is the undisputed gold standard within the athlete performance testing. Blood testing has loads of research behind it, and this research has been built upon by innovative companies such as AthleteBloodTest.com (ABT). For example, ABT research has established ideal ranges of many blood tests for athletes based on age, gender, and frequency/duration/intensity of training.

Highlights:

  • Undisputed Gold Standard
  • Extensive and innovative research

Lowlights:

  • Data is only truly useful when interpreted by an expert with extensive training on biomarker monitoring in athletes (aka to get useful information you must use a service like AthleteBloodTest.com)
  • For biomarkers that fluctuate, such as cortisol, blood testing provides only a snapshot. Thus, athletes with borderline “functional” disorders may be missed on a single test unless more extensive panels providing cross references are performed. Example: ABT Gold Panel vs. Bronze Panel.
  • A visit to a blood draw lab is still required. Accurate results and comprehensive testing are only available through venous blood, which requires a blood draw. Services offering testing through finger pricks offer a very limited test selection and the tests available through this method have limited use in athletes. Yes, a visit to a lab is a hassle, but the information is worth it.

Genetic Testing

Grade: B

Genetic testing as it relates to performance is still in its infancy. The possibilities within genetic testing seem limitless, however how to interpret and utilize the data has yet to be mastered. As an example, see the article “Genetic Tests Promised to Help Me Achieve Peak Fitness. What I got was a Fiasco”. In this article, the author gets 5 tests from 5 different entities offering genetic testing for peak performance. The results and interpretation of the results vary greatly, and even contradict each other between different testing entities. However, our high grade of a B for genetic testing is given because the information can be very useful when isolated to just proven biomarkers and compared to blood values. AthleteBloodTest.com offers a genetic component within our Platinum Panel in addition to blood. We use the genetic component to help provide deeper understanding of the relationship between blood levels and physiology (absorption, utilization), and determine the best course of action based on these factors.

Highlights:

  • When combined with blood tests, genetic tests can provide deeper understanding of why micronutrient levels are what they are and how to best manage intake or supplementation.
  • Many genetic markers are well studied and accurate
  • Easy test. Most kits contain a simple mouth swab and take just seconds to perform at home. Put the swab in the pre-labeled shipping bag and send it off.

Lowlights:

  • Of questionable value alone. Best use is when compared to blood test findings
  • Still much to learn for many genetic markers

Saliva Testing

Grade: B-

Saliva testing is easy, safe, and accurate…for SOME tests. Saliva testing is useful for testing certain hormones. However, beyond hormones saliva testing is of questionable value. The real highlight of saliva testing is its ease of acquiring a sample. Simply spit into a tube. For a hormone like cortisol, which fluctuates throughout the day, watching the fluctuations is possible. Thus, we can get a more complete understanding of how cortisol is reacting throughout the day.

Highlights:

  • Reliable and valid for certain hormones (especially cortisol, which can be tested over time)
  • Can easily acquire several samples in a day

Lowlights:

  • Value is limited being it is limited in its use. In the right scenario, saliva testing can be extremely useful, such as borderline over-reaching syndrome.

Intracellular Micronutrient Testing

Grade: Cannot award a grade due to limited science

Intracellular micronutrient testing is complex. In our early research we used intracellular testing as a comparison to blood testing. We had difficulty finding consistent associations. Is this because blood tests are inaccurate or intracellular testing is inaccurate. In the end, we chose to stick with blood testing research because of the validity, reliability, and volume of research that can be used to cross-reference our research results. A highlight of intracellular testing is the extensive panels and potentially the innovative thinking behind testing a more stable environment. A lowlight is the lack of comparison studies by which to compare validity and reliability, claims that are questionable, and results that are not tailored toward athletes. Thus, we can’t responsibly give intracellular micronutrient testing a grade. There is too much of the “unknown” and invalidated.

Metabolite Micronutrient Testing

Grade: Cannot award a grade due to limited science

Like Intracellular Micronutrient Testing, Metabolite Micronutrient Testing is also proprietary and severely lacking comparison studies by which to test validity and reliability. Also similar to Intracellular Micronutrient Testing, in our comparison research with blood studies we had difficulty finding consistent associations. Therefore, we are not able to provide a grade for Metabolite Micronutrient Testing.

Hair Analysis

Grade: D

Hair Analysis is a newer offering in the sports field. This is largely being used by solo practitioners and has not hit mainstream. In our research

Hair analysis is an accurate method for determining illicit drug use. A study in the May 2013 issue of the Journal of Clinical Endocrinology & Metabolism also concluded that hair analysis can accurately determine average cortisol levels over a three month period. Although it does not appear to be able to land on an exact number, determining whether cortisol levels run high, average, or low can be determined. This could be useful if chronic adrenal fatigue is suspected, although historically being “high, average, or low” has extremely limited clinical relevance. What matters is what the condition looks like now.

Most importantly in discussing hair analysis is noting what hair analysis cannot accurately determine. Hair analysis is plagued by inaccuracies and poor research results for the use of determining micronutrient levels in the body. Blood testing is the gold standard, is more accurate, and more affordable.

In order of most effective to least based on our Four Factors at the beginning of this article:

Test Grade
Blood Testing A
Genetic Testing B
Saliva Testing B-
Intracellular Testing No Grade Given
Metabolite Testing No Grade Given
Hair Analysis D