Endurance Planet

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Back on EP is our friend, The Sock Doc, aka Dr. Steve Gangemi, to discuss the real deal with Vitamin D--yes, it's super important, but are we over-hyping its importance and the need to supplement these days? It turns into quite the discussion! Before that we catch up with The Sock Doc on his new book, The Systems Health Care Manual, a 175+ page manual geared toward practitioners to aid in evaluating, diagnosing, and treating patients. You don't have to be a practitioner either to benefit from this manual! Get it here. Also: We ask Steve how to find a good chiropractor and/or massage therapist? Do we need both?

On Vitamin D and other essential vitamins and nutrients:

• Vitamin D's importance for athletes and the general population, but we take a critical look. What D actually does for us, the active form of D (and the conversion that takes place in our body for the active form of D), measuring in blood labs, optimal levels, supplementing with D and dosages, ways to get D more sun to get your D.
• Clinical history: Vitamins E & D
• Vitamin E was the big hype back in the day: people told to supplement, usually was synthetic form, led to hormonal issues, common problem associated was hip pain, with less E supplementing improvements occured
• Now, these days Vitamin D is the big hype
• A lot of experts and studies say we need to "get our Vitamin D up," is this valid?
• Discussing normal ranges and units used, ng/ml vs. nmol/L
• What about Vitamin A? (Great for immune wellness)
  • Why Steve says he's often more inclined to prescribe Vitamin A for a client than D
  • Often fear associated with Vitamin A due to potential side effects, toxicity issues, and liver issues.
  • Types of Vitamin A—check the labels on your supplements to see what you are really getting. (beta carotene, palmitic acid, retinol)
• Signs of Vitamin A deficiency:
  • Frequent bladder infections
  • Itchy skin
  • Sore throat
• Critical nutrients Steve also likes includes
  • Glutathione
  • Fish oil(s)
• Vitamins A & D should be in 5:1 ratio
• Vitamin D3, is also known as cholecalciferol
• This becomes 25(OH)D, also known as calcidiol, in the liver and is best indicator of D status (usually measured in blood labs)
• With more niacinamide and iron, vitamin D becomes 1,25(OH)D, also known as calcitriol, in the kidneys. This is the most hormonally active form.
• D has critical roles in the human body—meanwhile, the risks of taking too much D
• What's measured in blood doesn't always tell the whole story
• Optimal Ranges of Vitamin D? There's a lot of debate:
  • Deficiency: in the teens
  • Gray area: 30-40 ng/ml
  • Optimal: ~ 50-80 ng/ml
• Vitamin D deficiency is common—why are we low in D? Factors:
  • Lacking co-factors for conversion to active form of D in the liver; need Mg and B3 for this
  • Liver is impaired
  • Deficeincy of something else inhibiting D production
  • Body's function impaired and unable to convert to active form of D
  • Immue issue, infection, etc.
• Cytochrome P450 pathway
• D3 vs. D2: why you don't want plant-based vitamin D2, especially in large doses
• D is often said to benefit athletes and increase performance including:
  • Increased skeletal muscle function, force and power production
  • Decreased recovery time from training
  • Increased testosterone production via inhibited testosterone aromatization—conversion of T to estrogen—and enhanced androgen binding
  • Decreases inflammatory markers, including alanine (ALT) and aspartate (AST)
• BUT are performance benefits seen in research limited to individuals who had a vitamin D deficiency to begin with?
• Other reasons for low D:
  • Not enough D because not absorbing dietary fat or not enough dietary fat in the diet?
  • Absorb more D with more fat! Nordic Naturals fish oil offers Vitamin D in the Ultimate Omega (get 15% off NN with this code: 114594)
  • Or not enough D because of low body fat?
• Genes, hereditary factors and personal experience of sun exposure for more D and better health
• Endogenously produced vitamin D
• Best Sources of Vitamin D
  • Fatty fish
  • Egg yolks
  • Quality dairy
  • Sunlight
• Role of Vitamins K1 and K2
  • Do we need K vitamins with our D, or are these not imperative?
  • Are K deficiencies a real thing?
• How do we really know if we are out of balance???
• Gut health
• Clearing up confusion, and take-home messages!

Resources

• Effects of Vitamin D Supplementation on Muscle Strength
• Plausible Ergogenic Effects of Vitamin D on Athletic Performance
• More on Vitamin D from The Sock Doc

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• Wanna run Ragnar SoCal with the EP crew? Email us at [email protected].
• Have a question for any of our shows? Send to [email protected].
• Discussing Tawnee's MAF Test and "starting from scratch." Takeaways for YOU in your own testing and analysis with the MAF Method.
  • Get full details on Tawnee's MAF test on her blog here.
• On race weight and how to find optimal body composition without being too light... An EP fan wonders if he should drop more weight before the final race in a series where he's currently ranked high.
• When cutting back on calories and trying to drop pounds can backfire if too extreme.
• Focusing on how you feel and perform, not a number on the scale!
• Cutting back on strength training and weights before A races, not only to avoid excessive fatigue but also optimize body composition for endurance.
• On finding your healthy weight and avoiding the horrors of trying to be skinny for your sport; why Tawnee will opt for extra bodyweight and just get stronger to carry the load!
• More on the risks of underfueling as we discussed on ATC 215. One listener chimed in to share his story.
• We talk about how you can't really just pick a race finish time and achieve it, it's not that easy, but when it comes to goals and seeing what it takes to Kona, can you chase times???
• Have you reached your race potential? Can you still find more speed and get that next level?
• On the deep competition in Ironman and Kona qualifying at amateur ranks and realistically figuring out if you have a chance.
• The No. 1 thing you can do to find out if you have more: Get a coach.
  • Also, training alone may not be enough to get to your potential, take the holistic approach and do further functional health testing and monitoring to assess current health (any deficiencies or additional support needed?)
• Trekking poles for ultra: yay or nay?
  • Tawnee on her love for trekking poles and which kind she got here.
• Adding a bike commute to work during MAF half-marathon training. Should these commutes replace a run or run(s)? Should it just be added to the run schedule as another workout?
  • Discussing stress is stress is stress and if you add more why you want to be careful in not making it too much.
  • But it depends: You need enough runs to get the stimulus to get better, and too much crosstraining will not benefit running to a certain degree.
  • Figure out: How many runs per week, the "intensity" and duration of the bike commute, and the effective "dosage" to become a better runner.

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Dr. Tommy Wood and Chris Kelly of Nourish Balance Thrive join to discuss how athletes can go the next step in healing and bulletproofing their guts and bodies.

On this show we cover:

Exploring the Autoimmune Paleo Diet (AIP) and cutting-edge concepts to gut healing

• What is AIP?
• Foods removed are those with anti-nutrients, protease inhibitors, phytic acid, saponins, and with other known gut-irritant properties.
• The phases of AIP: elimination (all), reintroduction, rebuilding...etc
  • This process allows you to discover your own food sensitivities which a test may not accurately find nor show
• Why the AIP diet may be good for an endurance athletes and why one would undergo an AIP protocol?
• Athletes put their bodies through long periods of "stress" during exercise, and this can hurt our gut health, causing or worsening leaky gut/gut permeability
• While no research and just anecdotal evidence, the AIP may help an athlete suffering from gut issues in training/racing/in general (or other health issues) by eliminating "known irritants" to allow for faster healing?
• Chris shares his experience of the "old him" who was plagued with bloating, high inflammation (hsCRP) and even blood in the stool back when he was high carb. Since clearing much of his dysbiosis, he now uses AIP strategically before racing to ensure a strong gut.
• However, AIP is not meant to be a forever diet! Can be too restrictive if kept over time; missing out on variety and nutrients
• Is there any research on AIP protocols yet or just anecdotal? Any other research pointing to how an elimination diet can help heal gut/issues?
• There are many studies with lines that indirectly support the concepts of AIP but nothing specifically on AIP; i.e. studies show the benefits of removing foods with anti-nutrients and strategies to heal gut lining
• Tommy shares insight on the interpratation of reserach and using caution (example: a study that used raw kidney beans leading people to say "avoid beans!" but there are flaws in this logic)
• Sarah Ballantyne's website for a mountain of info on AIP
• What you CAN have on the AIP diet, and the foods to avoid
• Can AIP be too restrictive and depriving? Can it lead to cravings?
• Other possible AIP complications, like more food prep, shopping and cooking.
• What to avoid until symptoms dissipate: dairy, grains, nuts, seeds, eggs, coffee/caffeine, nightshades,
• Adjustment phase: breaking old habits, learning new habits.
• It's a mindset: embrace AIP as an opportunity! Not a diet of restrictions.
• Do you have to have an autoimmune condition to benefit from AIP?
• Can AIP become too high-carb and/or work against fat-adaptation?
• Tangent: CARBS AREN'T BAD!
• Tommy and Chris share different view points on carbs in the diet
• More on fructose, fiber, lectins, phytates
  • Tommy promotes a "mixed diet;" Chirs personally enjoys keto and will even make a LCHF version of AIP
• You don't have to have an autoimmune (AI) condition to benefit from AIP, but autoimmunity is on the rise in today's population and those with an AI issue will benefit with an AIP protocol
  • Taking a closer look at your symptoms, could it be signs of AI? Skin issues, gut issues, infections, etc.
  • If you have AI, you need carbs
• On feeling better with carbs
• Tommy: "Even if trying to be a fat-adapted athlete you need carbs to prime the system"
• Insulin: not all evil and when it is a good thing!
• Are high-fructose foods a problem and to be avoided?
  • If there's a malabsorption issue or bacterial dysbiosis in the gut
  • Athletes have "high turnover" so fructose may not be all bad
  • But, still, not always a ton of nutritional value in fructose foods so choose wisely
  • And more on FODMAPs
• Seeking solutions and avoiding symptom management

Other potential helpful and healing diets

• Nutritional ketosis, veganism, the specific carb diet (SCD), low fiber diets, etc.
  • Your choice depends on your symptoms and needs
• "How Not To Die" by Michael Gregor
• What are Lipopolysaccharides (LPS), and why are they bad?
  • Inflammatory, fat is transporting bad bacteria making it systemic
  • Relationship with gut dysbiosis
• On getting more and monitoring your micronutrients
• Pros and cons to saturated fats
• On low-fiber diets
  • IBS, constipation issues, and when we see improvements with this approach
• Not just diet that will cure: an "elimination season"
  • If symptoms or health issues are that bad, consider taking some time off from sport and competition to heal the body fully first

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Since going pro after a career in finance, Sarah Piampiano's accumulated multiple 70.3-distance wins, an Ironman win and many other podium performances, as well as a 7th place finish at the 2015 Ironman World Championships in Hawaii. This year she'll return to Kona. Last year she launched The Habit Project, an online community geared toward helping supporting positive habit changes. Along the way, Sarah has also struggled with Hashimoto's disease, a thyroid disorder, and was diagnosed as a young girl. On this show we will learn how Sarah has overcome Hashimoto's and still competes at the top level of long-course triathlon.

For more info on athletes with Hashimoto's and taking thyroid medication read "Thyroid Madness - Everything You Need to Know" by Steve Magness, who also has Hashimoto's.

On this show:

• Sarah's background from a career in finance to becoming a professional triathlete
• How she got into triathlon, and the bad habits she had prior to becoming a triathlete
• Hired coach Matt Dixon of Purplepatch Fitness, left job, moved across country to Los Angeles, began competing as a professional, and by April that year won Ironman New Orleans 70.3.
• Hashimoto's and Health Struggles
• Struggles as recent as this year, 2016, coming off Kona and an Ironman win late last year.
• Diagnosed with Hashimoto's when young, this is a thyroid disorder in which your body recognizes your thyroid gland as a foreign body and attacks it.
• Managed it through medication but things were starting to go bad into the triathlon days.
• Broken leg in '14 leading to investiage current thyroid status--what was going on and the link to the fracture and overall health
• Diet changes that Sarah made early on
• Still seeing low thyroid functioning and increasing med's
• Energy struggles
• Tons of inflammation and swelling. "To the point that sometimes – if I ate something 'off' – I would retain upwards for 10-12 pounds of fluid as my body reacted negatively to whatever I had consumed," she says.
• Inflammation after an Ironman
• Ice cream and swelling after Kona '15
• Tackling an elimination diet to heal from within and boost thyroid function; also to fully understand what foods were causing the swelling and inflammation.
• Removal of grains, sugar, alcohol, legumes and dairy. Still allowed to eat protein, fruit, nuts and seeds, vegetables and potatoes.
• How she managed elimination diets in season or offseason as a pro triathlete who needs fuel and can't be too low carb
• Using the time after a race when training volume and intensity are low/non-existent to eliminate the "bad stuff"
• New diet was a huge turning point
• But still, living a life of balance and avoiding some treats--even if some consequences
• How she's learned to manage her condition, diet, and thyroid health to still train and race as a pro avoiding setbacks
• Lastly, Sarah shares about The Habit Project, and why she started it, its mission and more.

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• Chat about upcoming Olympics, in particular triathlon and favorites to win
• Water quality issues in Rio, should the athletes still swim despite the risk?
• Ways to reduce the bounds of our central governor, and train to be able to better override central governor when you need to.
  • Why are some people's central governors are stronger than others?
  • Getting outside your comfort zone often, using things like sauna to a point of discomfort, bikram yoga, cold water exposure, specific workouts (running, etc), and more
• Why are your shoulders and neck getting so sore and fatigued when in aero? And how important is it to hold the "turtle position" in order to properly utilize an aero helmet?
• The role of the T-spine in your bike comfort
• Tips to be a better "aero weenie" and/or "weight weenie" and the best-bang-for-your-buck upgrades to your bike.
  • A well-fitting triathlon bike, light and aero wheelset, aero helmet, clean (aerodynamically) cockpit, aero center pull brakes, Ceramic Speed oversize pulley system, ceramic bottom brackets, supposedly faster chains, and special gearing. A generalized version of this question would be
• How can endurance athletes benefit from knowing resting metabolic rate (RMR)? How can this information be used to benefit performance and recovery?
• The 'epidemic" of underfueling and learning how many calories you needs by breaking down your daily expenditure
• Given that (short) sleeved kits have tested faster and are becoming more popular why haven't we seen long sleeve kits yet? Is there even an advantage over short sleeved?
• More on the MAF Method being a "volume approach" to training. What does this mean? how much volume is enough? Can you cut from cooldown and add more volume to run time?
• Cooldown tips beyond walking
• Two biggest reasons people don't improve with MAF: 1) not enough volume; 2) underlying condition

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We're joined by Ironman statistician Thorsten Radde, of www.trirating.com, for another installment of TriNews. It's a pivotal point in the season with the first round of Kona Qualifiers announced based on the current KPR rankings. Who's going to the Ironman World Championships this year?! We discuss that and much more:

• Ironman Frankfurt and the hypothermia situation
• Iron Trivia! Play along as Thorsten challenges Tawnee with these questions:
  • Fastest IM times of 2016 on bike, run and overall
  • IM winning streaks (lots of wins at one race or wins year by year on different courses)
  • Home wins
  • Unbeaten Kona rookies
• Challenge Roth, another record-breaking day
• Daniela Ryf's back to back weekends of racing
  • Discussing Daniela's bike strength (4:31 at Roth) vs. Rinny's run strength (2:49 at IM Austria), and the great battle it will be in Hawaii this year
• KPR July cutoff news
• Who's in for Kona so far (40 males, 28 women, plus AQs), who's on the cusp, who's out
• We discuss the guys and gals who will be toeing the line in Kona this year
• Plus more insight, Thorsten's analysis, and stats

Resources

• Get Throsten's KPR Observer (right-hand column)
• Trirating.com: The 'unofficial' KPR July cutoff slot allocation
• Trirating.com: Current top 10 ratings
• Ironman's KPR System
• Current KPR - Women
• Current KPR - Men

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A special edition of Endurance Planet with Tawnee and her husband, John, who are interviewed by Lucho about their backpacking honeymoon! Click here for the full written recap of the trip on Tawnee's blog that includes more photos, GPS files, and a detailed spreadsheet of their exact gear list (with brands), meal plan, HST itinerary, travel info and more.

• Background on why they did it and what they did (what is the High Sierra Trail)
• They wanted to create their own event--not participate in a structured event with rules
• Discussing the original conservative plan vs. how the actual timeline unfolded--finishing 2 days early!!
• Preparing for the trip (planning, shopping, training, mental, etc)
• Lessons learned: they could not treat this immense thru-hike like a race, and had to get over the "racing attitude" that's usually ingrained
• The mental and physical of backpacking vs. endurance racing
• It's not easy to backpack, it's also not as hard as preparing for Ironman, it's just different
• Having a new concept of what "a mile" means. And why it's better to focus on time!
• Mileage was always off, couldn't rely on trail or map numbers, just accept it and keep moving forward
• Having patience and a flexible approach
• Dealing with blisters
• The simplicity of being out in the backcountry: everything to live was on our backs
• Day 4: Tawnee deals with a visit from an "old friend" and how she managed
  • Girls, get the Diva Cup!
• Day 6: Climbing Mt. Whitney and feeling those old "pre-race butterflies"
• "Performing" at elevation, and/or feeling like death over 13,000 ft.
• Tying this into races at high elevation like Leadville, etc.
• Similarity of picking ultra pacers and picking your backpacking partner(s)
• The importance of TEAMWORK!
• Finding a routine in the mornings and evenings before and after they day's hike.
• Backpacking vs. ultra (mindset)
• Feeling "free" without being addicted to the data--a shift from past ways
• Equipment highlights:
  • Delorme - safety net in case of emergency
  • Garmin watch - good backup for tracking hikes
  • Trekking poles - and why they were the best decision ever to have these on the trail!
  • Shoes and blisters - harsh realities
• Top experiences on the HST:
  • Kaweah gap
  • Getting completely on the same page with your mate
  • Summiting Mt. Whitney
  • Precipice Lake
• What would we do differently?
• Little mistakes: poor choice in mittens/gloves, accidentally brought multiple soaps yet not enough floss, no SD card in GoPro, bad socks, solar panel vs. battery packs, different shoes, etc.

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We are back with the godfather or health and wellness for endurance athletes, Dr. Phil Maffetone. Today we dive into the tricky subject of how to achieve a healthy hormonal status while still training for your sport. That is, how we can participate in sport--even at highly competitive levels--and save our hormones from tanking or fix them if we're in a bad place. Plus: Q&A on common MAF Method follows.

Can you get to that high end of performance and still be healthy?

• The "gray area"--things change every day, and we MUST monitor athletes closely.
• Always assess and reassess athletes to see how much we can push. (A good coach should do this, but self-coached athletes should do it too.)
• Low hormone levels in endurance athletes usually due to HPA axis dysfunction.
• The HPA Axis dysfunction leads to a reduction in health over time in the pursuit of fitness, and eventually performance.
• Common issues: low/no progesterone/estrogen in females, low T in males, or some combo.
• Adrenal issues, and Phil's take on "adrenal fatigue."
• The role of stress. We need stress in order to adapt, but we need to manage stress to not go overboard into unhealthy territory.
• How do we manage? Monitor all the clues, red flags, symptoms, etc, that the body exhibits. Monitor often.
• Sharing brilliance from Dr. Tami Meraglia on Bulletproof Radio: The top 3 questions to ask your doctor.
  • What effect does nutrition have on my health?
  • hat do you think about the difference between normal lab ranges, and optimal lab ranges?
  • What do you do if what I'm telling you (signs, symptoms), doesn't match the lab results?
• Some examples of random but important symptoms: frequent urination (especially at night), salt cravings, low blood pressure and getting lightheaded often.
• Phil chimes in on the often-sketchy nature of blood chemistry at not telling the whole story
  • Calcium ranges in blood labs
• Saving your hormones the all-natural way for your own well-being and also follows rules of sport's governing bodies, WADA, etc!
• So, should we just supplement with testosterone if our T is low? No! Instead, figure out why it's low and fix naturally.
• Phil talks on the risks and harms of supplementing with testosterone for non-competing athletes, non-athletes, or athletes who choose to supplement regardless of rules.
• For women: temporary supplementation with progesterone cream when it's needed is legal, and safe, and it may work.
  • Tawnee shares her experience on using progesterone cream with success to help the body re-learn to produce and use this hormone--then weaning off.

Is 'Slow' MAF causing pain or injury and getting you 'nowhere'?

• If you have to slow down upon starting MAF to hold target HR and you're significantly slower than before, ongoing, as such some report that these slower paces cause more aches and pains and sometimes injury (more pounding, harder on the body to run slow, etc), so what's the remedy?
  • When starting MAF you have to start a full program to address all variables and be proactive: fix muscle imbalances, wear the right shoes and/or practice barefoot, adopt healthy nutrition, and so on, to avoid these issues from taking place.
• Can you be "so slow" at MAF (i.e. walking or really slow jog at target HR) that it has no benefit as it relates to increasing run speed/fitness?

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Episode 214 of Ask The Coaches with Lucho and Tawnee providing answers to your questions and discussing the latest and greatest for your endurance training and racing.

Announcing Ragnar SoCal 2017! We are building the team(s) now and plan to finalize within a month or two so if you're interesting in a life-changing epic experience running with Lucho, Tawnee and the Ragnar crew email us at [email protected] to lock in your spot right away. We hope to have a normal 12-person team and also introduce an ultra team for the 2017 event!

• We discuss results of the new study 'Effects of Energy Drinks on Economy and Cardiovascular Measures' in the Journal of Strength and Conditioning Research
  • Drinks used: Red Bull, Monster and 5-Hour Energy (with the placebo as Squirt soda).
  • Protocol: Drink, wait, run; what was measured; and outcome.
  • Energy drinks don't increase performance but do raise systolic blood pressure.
  • 5-Hr Energy decreased RPE... is this a good or bad thing? We discuss.
  • "First, there were no improvements in economy noted in this study. Second, energy drinks impact cardiovascular function at rest and during exercise. The small increase in systolic blood pressure (3.84 mmHg at rest and 8.81 mmHg during exercise) may not have a negative health impact. However, it is recommended that individuals be aware of the increase in blood pressure."
  • Take-homes, practical application and our two-cents!
• On switching from ultras back to marathon road racing, and how to dial in marathon pace for fast and flat racing that is so different than ultra trail pacing?
• How to predict marathon pace using a field test of 3 X 4 miles at goal pace (or something close to that workout)
• How to predict marathon pace using your MAF test. Read Phil's full article including years worth of data they've accumulated.
• Fitness has gone south, and feeling like MAF may be the answer to come out of the rut. But skeptical and still feeling like Joe Friel's "use it or lose it" makes sense. Move forward with MAF?
• How old was Lucho when he dialed in his MAF pace to be 5:55/miles? And other variables that led to Lucho's killer MAF pace!
• Our EP podcast with Phil Maffetone addressing when to add intensity with the MAF Method
• Scheduling long run and long bikes for the weekend: Which one would be best to schedule first if you can't do 'longer' sessions during the week?
• Doing the run on Saturday--is it better to run on fresh legs to limit any injury caused after a long ride day?
• Vs. doing the run on Sunday to simulate the run portion of half and full distance triathlons?
• And what about doing a big brick on the weekend--long bike and long run all on one day with the added bonus of practicing race nutrition!
• Followup from a listener who's implemented MAF and more carbs to decrease stress, help performance and be healthier--and is seeing the benefits.
• "I have been strictly MAF'ing it on the run and am now at an 8:45 MAF from 9:45.... I have found that I really need to add in some CHO in the evening meal."
• Tawnee rants a bit on carbs and fat-adaptation--athletes don't have to be very low carb to get fat adapted!
• Nose breathing as an additional way to gauge your pace, avoid too high stress, and run smoothly.
• MAF and the effect of heat! Argh! Do we adjust MAF HR? Flub it ~ 5 beats allowing HR to increase? Stick to strict MAF and slow down, or what?!
• Using MSP (maximum sustained power) workouts, but getting really bad DOMS. What to do?
• What does an MSP (maximum sustained power) workout entail?
• Case study: 59-year-old female, with chronic Achilles injury and recently diagnosed Hashimotos thyroid disease, now taking hormone medication. Goal is to do a half marathon in 2017. MAF HR is super low at 106 and finding it near impossible to run, bike and hike keeping HR at or below this; it's affecting quality of life! Should she give up everything for a while? Still bike and hike and allow HR to go over 106? Go back to 121 HR that was being used before the adjustments to MAF for illness, meds? Lost on what to do...
• Prioritizing goals: Health first including healing the autoimmune condition, meanwhile still be active doing what you love (hiking, etc), and have patience with structured running training until condition improves. It's hard to heal a health condition while trying to train for a race!
• Also a note on natural healing and alternatives to traditional hormone meds.

Resources on Autoimmune Healing (for thyroid, etc):

• The Thyroid Cure by Michelle Corey
• The Autoimmune Solution by Dr. Amy Meyers
• What Your Doctor May Not Tell You: Autoimmune Disorders by Deborah Mitchell

We're back with Episode 4 of "So You Wanna Go Pro" featuring elite triathlete Matt Bach. This episode takes an unexpected and somewhat ironic turn of events. Listen to Ep. 3 here.

• Matt discusses recent developments in his health & plans to heal:
  • Diagnosis: Stress reaction in femur, osteoporosis, and double genetic mutation in MTHFR with C677T variant
  • What's a stress reaction vs. fracture, why did this happen, risks, treatment (was on crutches for 6 wks), plan
  • Bone health and association with low testosterone
  • Leanness, calories, nutrient absorption and more
  • Immediately ceased all focused training and racing
  • It takes many months, or even years, to destroy T levels and bone density; will take months to restore it
  • Matt's T #s already improving along with better energy and libido
• Matt shares a non-scientific survey he did of 22 elite/pro triathletes and their hormonal health & more research:
  • 13 diagnosed with hormone problems, 6 have symptoms but no official diagnosis, 3 reported no problems
• Will Matt still pursue going pro?!
• Getting more answers with further testing such as 23andMe soon
• Further research shows: >3 risk alleles = greater risk (30% vs 5% for 0 risk alleles)
• On MTHFR: Very common! Body less efficient at producing an enzyme that converts inactive folic acid into active form of folate (i.e. 5-MTHF)
  • Why most of us want Methylated folate/5-MTHF vs. folic acid (and brands we trust for supplementing i.e. Thorne)
  • Folate helps with cell reproduction
  • Also the role of B12
  • Recommended supplement to boost methylation
• Matt's approach to healing via nutrition, supplements and lifestyle:
  • All-natural approach, taking nothing that is banned. Plan to return to competition, don't want side effects
  • Picking the right team of doctors
  • Not much endurance training (1x per week swim/bike)
  • More sleep
  • More social time and time with wife, Lauren!
  • Physical Therapy
  • Strength work
  • On diet: Continue eating clean and healthy, Metabolic Efficiency Training, and figuring out if this is the right "diet" for Matt still?
  • Tons of Supplements, some temporary
  • • Strontium, multivitamin, methylated folate and B12, magnesium
    • Increased to 5000 IU D3, D-Aspartic Acid Powder, BCAAs, Pregnenolone
    • Omega-3s
    • Also a Probiotic, vitamin K2, Selenium, vitamin C, CoQ10 and Gaia HPA Axis
• Psychology and ongoing plans to go pro:
  • Pro plans on hold, but not gone, patience to heal first is key!
  • Not as restless as expected with changes
  • Headspace and mental work to stay happy and motivated
  • Off crutches, can't run still, but Alter-G soon
  • Sponsors awesome, continue to support; new ways to help them
  • What others are saying to Matt
  • The influence of other athlets struggling, and how Matt is finding solace in their stories on overcoming hardship

Resources

• Ep. 1: So you wanna go pro
• Ep. 2: So you wanna go pro
• Dr. Phil Maffetone on Folate vs. Folic Acid Pt 1
• Dr. Maffetone on Folate vs. Folic Acid Pt 2
• Dr. Maffetone on Folate vs. Folic Acid Pt 3
• Dr. Ben Lynch's mthfr.net website for more on this common gene mutation
• Dr. Tamsin Lewis on MTHFR
• Cody Beals' blog
• Matt Bach's blog