Tuesday, September 23, 2008

Sports Medicine Series #1

Since I'm stuck at the Denver airport on my way to the triathlete paradise that is Las Cruces, NM, I thought I would start my sports medicine series! The plans include a 3-part series on injury prevention for the swim, bike and run and maybe a short one on sports nutrition, but that will most definitely be a do as I say, not as I do editorial. My nutrition stinks, unless you consider living on Cliff bars and oatmeal proper nutrition. But for today a blog about Supplements!

Do you need supplements? Heck no. I would have keeled over long ago since I have a bit of a problem remembering to take them (maybe I need one of those memory boosting herbals....). But I do believe that there are a few winners out there with some decent evidence behind them.

In no particular order...

A good strong multivitamin

As triathletes were tend to be a bit obsessed about our weight (free speed). In doing so, with a heavy training load it's easy to get behind on some of the building blocks. ESPECIALLY the vegetarians and vegans out there. If your nutrition is suspect and you think you probably live on a bit of a deficit, get a multivitamin that provides a strong dose of all the B- vitamins

Downfalls: Fluorescent pee.


This is a bit individualized. Men with good intake of red meat will probably not need any additional iron (and it could be dangerous). However, iron is one of the many nutrients that we tend to lose in sweat, so it is not entirely uncommon for athletic men to be iron deficient. Of course iron is lost in blood as well, so the women among us could probably benefit from a low dose supplement. If in doubt, the next time you see your doc ask for a CBC and iron panel to see how you're doing. A note for vegetarians- many vegetables are high in iron. But don't let that fool you! Iron if veggies like spinach have a very low bio-availability so most of it goes right through and doesn't get absorbed. If you eat no meat, a low dose iron supplement is probably a good idea. *Hint* If you are going to supplement with iron, buy "Gentle Iron" or iron bisglycinate. Unlike iron sulfate, it is easy on the gut and does not constipate. Look for a formulation with vitamin C, because this aids in absorption.

Downfalls: Iron is dangerous in high doses. If your diet is rich in iron and you have never had a problem with anemia, you can skip it.

Fish Oil

My favorite of the supplements. I think fish oil is the magic pill. Shown to decrease inflammation, heart disease, arthritis, and for us athletes there are several studies showing its efficacy in reducing exercise induced asthma.

Downfalls: Fish burps, some minor bruising. Discontinue before surgery unless you want your surgeon to call you bad names in the OR since it is a mild anti-coagulant


Glucosamine is thought to decrease progression of osteoarthritis and joint pain, although some of the studies are still a bit conflicting. One thing that is true, though is that the supplement doesn't interact with other medications and has virtually zero side effects. The only caution is for people with shellfish allergies. So if you are someone who is running with joint pain due to cartilage damage, this might be a good choice for you. Give the supplement a few months of use before making a decision on whether or not it works for you.

Downfall: Can be spendy, but there are cheaper options at the large wholesaler-type stores.


When I first heard that people supplemented with glutamine I thought it was ridiculous. What good could a single amino acid do? So I hit pubmed and was totally shocked at what I saw. Glutamine is a primary fuel source for our immune cells. It is also among the first amino acids to be depleted when the body is under stress. Supplementation with glutamine has been shown to boost immune function and insulin activity in hospital patients. Studies on the effects of glutamine supplementation in athletes are still a bit controversial. But my take is that it is worth supplementing with some glutamine in your recovery shake after particularly hard workouts and races. Anything that can prevent the dreaded build week colds is worth trying!

OK, that's all I have for now. If I think of anything else I'll be sure to add it. For now, I have to figure out where my flight to El Paso departs from. I have some training to do this afternoon!


triguyjt said...

great advice...

lately my pee has been fluorescent......so there you have it....

Brian said...

Excellent post. And we don't even have to pay for it. When you say decent multivitamin is centrum in that category of decent?

Can wait to see the rest of the series. As for bike injury prevention, you know my advice. Watch out for those pesky right turns and your rear tire.

Chad said...

Thanks for the great advice. Have a good time training in NM. Hopefully it is cooler there than it is here.

Steve Stenzel said...

Thanks for the post! Great stuff!

I take a multi-vitamin now-and-then, but I've never had Fluorescent pee. Does that really happen?!?! I kinda want to go overdose on my multi-vitamin to see that happen!!

Maggs said...

Thanks for the advice. I take them all except L-glutamine. Well, I take krill oil, which is supposedly more 'potent' than fish oil and since it causes serious bruising vs just minor bruising, I guess it is.

khai said...

Where do the M&Ms fit in?

Shawn and Tracy said...

Thanks for all the info Doc. I never knew how beneficial fish Oil was. I am adding it to my list.

Anonymous said...

Interesting stuff. I'm a vegan, but the only supplement I take is a daily multi-vita. No problems in the balance though, I don't think, at least from the tests the docs do, lol. I've had some people suggest the supplements you mentioned, good to know more about them a bit. Looking forward to the rest of the series :-)

erichollins said...

Yeah, I had the florescent pee. It is quite embarrassing when you pee in the pool and it looks like Mt. Dew.

No iron for me because I'm borderline hemochromatosis.

Dropped the fish oil because it was expensive. I should probably pick it back up.

I was on glucosamine for the longest time when I was playing ultimate frisbee, but now that my knees are better, I don't take it anymore.

Never done the L-glutamine but I've heard good things about it.