Blood Pressure in Athletes and Runners

It has been well established in countless studies that moderate levels of routine aerobic exercise can help decrease blood pressure in populations with high or normal blood pressure.(1) The American Academy of Family Physicians cites the prevalence of hypertension in fit individual is about half of the general population, but adds that some athletes may have an increased risk of hypertension.(2)


Other studies indicate the systolic blood pressure (top number) is elevated during exercise and after exercise for about 2 hours. After the 2 hour mark the blood pressure tends to stay lower for 1 to 3 days.  (3,4) After 3 days the effects of exercise tends to diminish. Because of the diminished effect, experts agree that moderate aerobic exercise on most days of the week is important to maximize the benefits for blood pressure reduction.

Does type and volume of exercise impact blood pressure?

A recent review paper found that endurance trained athletes have a lower blood pressure compared to strength based athletes. (5)   The National Runners’ Health Study , a cross-sectional study conducted in 1997 concluded that runners averaging 50 miles per week or more had slightly lower blood pressures levels than those running less than 50 miles per week and that running in general lowered blood pressure.(6) This type of study design shows correlation but does not prove causation.
For now, the most recent data suggest that moderate amount of aerobic exercise (including running) is beneficial for blood pressure health.


Looking to optimize your performance for your next race?
We specialize in biomarker analysis aimed directly towards improving athletic performance. Learn more about our panels here.
  1. Vasan RS, B. A. S. S. L. M. K. W. D. R. L. D. Residual lifetime risk for developing hypertension in middle-aged women and men: The Framingham Heart Study. JAMA.,2002 Feb 27;287(8):1003-10.
  2. The American Academy of Family Physicians: Managing Hypertension in Athletes and Physically Active Patients (
  3. Ruivo JA, Alcantara P. Hypertension and exercise. Rev Port Cardiol.2012 Feb;31(2):151-8. doi: 10.1016/j.repc.2011.12.012. Epub 2012 Jan 10.
  4. Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002 Apr 2;136(7):493-503.
  5. Berge HM et al.  Blood pressure in elite athletes: A systematic review, Br J Sports Med. (2015)
  6. Williams PT,Relationship of Distance Run per Week to Coronary Heart Disease Risk Factors in 8283 Male Runners The National Runners’ Health Study, Arch Intern Med. 1997 Jan 27; 157(2): 191–198.

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Written on March 18, 2019
By Ofer

Avoid the training bonk!

We are very often counseling our athletes to not just test when they’re feeling symptomatic of something.  Sure we can help you identify why you’re symptomatic and what the proper coarse correction is, but we’d rather help you avoid the symptoms to begin with!

Thomas Gerlach is a Professional Triathlete who has been using ABT in this capacity for years and states this perfect, “As endurance athletes we push our bodies beyond what they are designed to do and it is important to be proactive and identify deficiencies. Too often as athletes we are reactionary and dig ourselves in to holes before we finally capitulate and seek answers. The reality is that it can take weeks, months, or even years to fix those issues. The goal of my blood testing is to stay proactive and identify minor cracks before they become holes.”

Using as an early warning system has become a staple of his regiment.  He goes into great detail on his latest ABT findings and you can read first hand how he is proactively addressing deficiencies and making consistent tweaks to avoid the training crash:

Written on March 5, 2018
By Scott Evans

Understand the importance of knowing your physiology and how it’s directly correlated to your performance. Listen to the expert, The Happy Athlete.

Understand the importance of knowing your physiology and how it directly is correlated to your performance?  Listen to the expert, The Happy Athlete.

Dr. Joe Sheppard runs The Happy Athlete (, which is a website dedicated solely for the athlete and provides reviews of various products and services that as athletes, we all use.  I would suggest you check it out and use as one of your key resources!

ABT was fortunate in that we were reviewed by The Happy Athlete for our Gold Panel.  In the article he states, “There are several key elements I like about ABT not only did it give you the necessary physiological information, explained that valuable information and made ideal dietary and nutritional recommendations that would change my blood chemistry over future testing protocols. Typically, the knowledge and information in Physician Blood testing was not explained in this extensive detail through a general practitioner office.”

For the full review, visit:

Written on January 5, 2018
By Scott Evans

How low iron ended a season

What happens when your metabolism essentially shuts down on you? “After what would be a normal work out for me and feeling the obvious fatigue I was experiencing, it became clear I had a bigger problem” says Betty Elite and athlete Susan McNamee. She got into endurance sports later than most and the majority of Americans have resorted to a relatively sedentary life void of any major challenges. Not Susan McNamee!

Susan opted to challenge herself by entering her first Ironman 70.3 as well as other races. After completing her first race she put the pedal to the metal completing 4 Ironman races, several Ironman 70.3 races, running races, and much more in the next 3 years. She was having so much fun that she didn’t notice her body was slowly shutting down. It was during an open water swim prior to two key races that she realized that something was “off.” Her whole body felt like “dead weight with no energy, even mental fatigue.” She tried to see if anything would be different on her bike as this is her strongest discipline. Once things didn’t feel any better, she knew something more fundamental was going on more than just an off day.

She began seeking answers, which included seeing her primary care doctor, various specialists, and performing her own research. After it all, she was still left without answers and without improvement. Susan decided to request a blood panel through her primary care doctor. She had enough working knowledge to know what tests may provide insight into what was going on. The tests were performed and her doctor shared the results. “Everything is within normal ranges”. Susan was again left without an answer.

Ironman Canada, the race she was preparing for came. Susan decided to toe the starting line. Within the first half of the swim she could tell that she didn’t have it. She’s used to finding the dig deep zone. Susan couldn’t dig deep. There was nothing there. While holding onto a kayak she decided to pull herself from the race.

Frustrated by the inability to properly identify why she was feeling so lethargic, Susan decided to use with the encouragement of her coach.

Long story short, Susan found the answers she was looking for through (ABT). With the help of ABT, Susan has had her best year ever, qualifying for the Ironman World Championship 70.3, signing with Team Betty, and having more fun than she’s ever had training and racing.

Susan now realizes how important it is to consistently monitor her physiology. has played a big role in her successes. By identifying special nutritional needs, recovery needs, and physiological tendencies unique to her, she has been able to find consistency in her training and racing. Susan has avoided the problems that caused her body to crash before. Most importantly, Susan is able to enjoy training and racing more because she is feeling good!

Let provide you insights into your own unique physiology:


Written on November 2, 2017
By Scott Evans

Ever wondered how a pro triathlete such as Thomas Gerlach processes insights?! athlete, Thomas Gerlach lifts the hood on his own personal physiology and invites everyone in to see how he consumes the critical insights we provide him through our Performance Panels (

For him, it is very critical to his training and race performances that he is able to identify anything that is going on BEFORE it becomes a major issue.  See his full post for details:

Written on October 18, 2017
By Scott Evans

Ladies, Know Your Iron Levels!

Female Runner

Iron deficiencies occur in up to 50% of female endurance athletes. Yes, 1 in 2 of you will have inadequate iron levels and may experience some of the consequences commonly associated with iron deficiency; performance declines, fatigue, dizziness, higher than normal heart rates during exercise, delayed recovery from workouts, muscle cramps, sleep problems…all the symptoms you don’t want to feel during training!
This has been well reported and has led to widespread blind supplementation of iron. The result? Many athletes are making fundamental errors when treating themselves. First and foremost, identifying whether you need an iron supplement is very important. A recent study concludes that 11% of elite female runners have iron overload! This carries unnecessary general health risks. Secondly, if iron supplementation is needed identifying the appropriate dose of iron and form best suited for you is critical to getting benefit from your supplement.

What Causes Iron Deficiency?
Many factors influence iron levels. In athletes, some of the most influential factors include training volume, food preferences, food intake, menstrual cycle, and food quality. Although some of these factors can be partially controlled, other big factors cannot. For example, the food we eat nowadays is deficient in vitamins and minerals. According to Kushi Institute, analysis of nutrient data from 1975 to 1997 found that average calcium levels in 12 fresh vegetables dropped 27 percent; iron levels 37 percent; vitamin A levels 21 percent, and vitamin C levels 30 percent. The cause appears to be reductions in soil quality and vitamin and mineral levels secondary to “over-farming”. Another example of a factor that is not easily controlled is iron absorption rate. Absorption rates of iron are influenced by genetics, gut flora, intestinal health, and even psychological factors like stress.
Given the variables associated with an athlete’s physiology and the variables in foods/supplements, it is critical that you get your blood reviewed by a Sport Science expert.

“If you are a woman and train more than 5 hours per week you should have your serum iron and ferritin levels checked.” Susan McNamee, Betty squad 2017

Have questions, contact us:


Written on October 10, 2017
By Scott Evans featured by Red Bulletin – The Ironman Algorithm has been fortunate enough to be featured in a great article written by Will Cockrell with The Red Bulletin.  He does a fantastic job of telling the story of elite endurance athletes and how they use sports science and technology advancements to drive better performance.

What is even more interesting is how the innovation starts with the professionals, but the common athlete often is the biggest benefactor of these advancements.

Check out the full article at:

The ABT Team

Written on September 22, 2017
By Scott Evans

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

Questions contact:

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 (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.


  • Undisputed Gold Standard
  • Extensive and innovative research


  • 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
  • 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. 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.


  • 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.


  • 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.


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


  • 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

Questions contact:

Written on June 2, 2017
By Garret Rock

Is There a One-Size Fits All Diet for Athletes?

For those of you “get to the point” people, the answer to the title is no. But, that is not the real point of this blog. Read on, it will be worth your time, I promise.

Dietary advice for athletes is everywhere. Bananas make you fat, avocados make you fast, asparagus is high in performance enhancing vitamins, Scottish Highland cattle have the perfect fat to protein ratio, and on and on. (Disclaimer: the preceding sentence is nonsense, do not take any of those claims seriously.) Then there are supplements. One could easily spend their monthly income on supplements if they took the many “performance enhancing” supplements advertised in the sports world.

So, what works and what doesn’t? This is one of the most common questions we get from athletes.

After 9 years of research we’ve found an answer to this million-dollar question. The answer is “all of it, none of it, and some of it”. There you go, thousands of hours went into finding this answer and we just shared it for free.

Let me explain.

We at Phuel Sports Science, the research entity offering, have been researching physiological responses to training and micronutrient needs in athletes since 2008. A clear conclusion we’ve come to is that every athlete has unique dietary and supplemental needs for optimizing performance.

We’ve examined our research in an attempt to identify trends based on gender and weight, level of performance, training plans, and everything in-between. Although we have identified some trends, ultimately the conclusion has not changed. Every athlete has unique dietary and supplemental needs for optimizing performance.

Identifying these needs is critical to optimizing performance. Whether optimal performance is getting faster or stronger, or simply enjoying the experience of training and competing more, knowing your unique needs is essential to achieving your goals.

In the research world, physiological needs and responses are often over-generalizing. For example, there have been many studies looking at whether a multivitamin can help performance. The research involves giving the experimental group a multivitamin and the control group a placebo (fake multivitamin in this case). The participants then run on treadmills or maybe stationary bikes regularly over a period of time. Conclusions of the studies cover the entire spectrum, concluding that multivitamins are detrimental to performance, improve performance, and everything between. Then an article is written in a magazine titled “Multivitamins Are Hurting Your Performance”.

Our research clearly indicates that we cannot generalize the physiological needs or response in athletes. This explains why studies such as multivitamin studies have conflicting conclusions, and why most unbiased supplement studies in athletes have conflicting results.

Our research has created an explanation for the many studies on supplements unable to come to a clear conclusion. For example, just some of the factors that influence dietary and supplement needs include:

  • gender;
  • age;
  • genetics;
  • environment (geographical location, work environment, home environment);
  • gastrointestinal health;
  • frequency, duration, and intensity of training/competition;
  • dietary habits;

Yes, it’s complex. So, how do you find the ideal diet for you?  There are two important steps to finding the right diet.

  1. Get a blood test through Testing is the only way to identify micronutrient needs unique to you.
  2. Hire help or do your research. Hiring the help of a dietitian will save you a lot of time and trial and error. A dietitian that specializes in working with athletes will be able to take the information provided through an Athlete Blood Test and tailor a dietary plan specific to your needs. It is well worth the money and the information remains pertinent for years.

There is only one way to truly identify how to optimize your diet, training, recovery, race preparation. That is through a blood test that tailors its recommendations to you as a unique individual. Visit and order your test today.

Written on
By Garret Rock