Podcast Episode 20: Relative Energy Deficiency in Sport (RED – S) and Hypothalamic Amenorrhea with Dr Nicky Keay
Relative energy deficiency in sport (RED-S) is the result of insufficient energy intake and/or excessive energy expenditure. Consequences of this low-energy condition can alter many physiological systems, including metabolism, menstrual function, bone health, immunity, protein synthesis, and cardiovascular and psychological health.
The RED-S concept has been adapted from a previously identified syndrome, the female athlete triad, which affects active women with low-energy availability, menstrual dysfunction and low bone mineral density.
New research suggests there may be a parallel syndrome in undernourished male athletes with resulting hypogonadotropic hypogonadism and impairment of bone health. Therefore RED-S is a more comprehensive model depicting a low-energy status in physically active women or men.
Today I have invited Sports Doctor Nicola Keay to explore the topic of RED-S deeper, look at the various influences exercise has on appetite, eating behaviour, its lesser known outcomes, diagnosis or red flags and treatment
Nicky studied medicine at Cambridge University, with clinical attachments including sports medicine clinics in Australia and University of Geneva. After gaining Membership of the Royal College of Physicians, Nicky trained in Endocrinology. As a Research Fellow at St Thomas’ Hospital, she was part of the international medical team which developed an anti-doping test for growth hormone. With sport medicine grants, Nicky researched and published on the training effects on the Endocrine system. Recent publications include competitive male cyclists and relative energy deficiency in sports (RED-S). Nicky is currently researching the risk of RED-S in dancers and athletes.
Nicky wrote the British Association of Sport and Exercise Medicine educational website Health4Performance on RED-S, is the medical advisor to the Scottish Ballet, part of the multidisciplinary team at EN:SPIRE clinic for dancers and athletes and Chief Medical Officer of Forth Edge, providing medical interpretation of blood tests to athletes.
Nicky shares her personal story and that even as an early medical doctor she did not realise she had a serious problem.
To learn more about Nicky you can check out her website or follow her on Instagram @nickykeayfitness
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