Athlete overtraining syndrome, or OTS, is the result of excess training without adequate recovery. As a ‘syndrome’, it’s a collection of signs and symptoms that aren’t well defined from person to person. OTS leaves you feeling flat, fatigue, depressed and unable to perform anywhere close to where you used to, seemingly without any reason.

Perhaps the most frustrating aspect of OTS is that it’s not easily treated. While OTS is well studied, it is still relatively poorly understood.

In a nutshell, the symptoms of OTS are caused by imbalances in our neuro-endocrine system, or the part of our physiology that ties our brain to the rest of our body, via the hormonal pathways. This is caused when stress (physical, mental and emotional) exceeds the brain and body’s ability to cope.

Our brain perceives and interprets stress – whether it’s an argument, a poor night’s sleep, or too many hard workouts – in the same way, by responding with the production of hormones that help our physiology ‘deal’ with the stress. Basically, after too much stress (in this case, too much training without adequate rest), the system becomes dysfunctional and cannot do its job properly, hence the common symptoms of OTS

Mainstream medicine is ill equipped to deal with OTS effectively. The answer doesn’t lie in medications, as the symptoms of OTS aren’t treatable with drugs, under the surface at least. Unfortunately, many athletes are misdiagnosed with depression rather than OTS; the problem is that yes, the athlete is depressed but not because they’re suffering from an antidepressant drug deficiency!

Treating OTS requires a detailed plan that involves nutrition, rest, and specific nutraceuticals that help heal and balance the intricate balance of the neuro-endocrine system.

Each athlete’s presentation of OTS differs; hence treatment plans will vary from person to person, as will the time it takes to recover.

Briefly, here’s how we approach taking care of athletes with OTS:

1. Proper diagnosis of Overtraining Syndrome.

I can’t emphasize this enough! OTS can masquerade in part, as several other more common health conditions. The following should be ruled out, at a minimum:

• Thyroid disease
• Poor/Imbalanced diets (anemia, mineral deficiencies, suboptimal protein/carbohydrate/fat intake)
• Excess mental emotional stress or disorders like anxiety or depression
• Chronic illness (mono, celiac disease, parasitic infections, etc)

2. Rest

Without rest there is no recovery, period. OTS is ultimately caused by inadequate recovery. The rest period required to recover from OTS can be many weeks to even months.

3. The Importance of Diet in OTS

Diet plays an important role in OTS. While individual dietary needs are important, there are specific guidelines that a person with OTS should adhere to in order to maximize recovery.

4. Adrenal Hormone Evaluation

Depressed levels of testosterone and estrogen are common findings in OTS, however replacement of these hormones doesn’t address the root cause, and isn’t an option in athletes due to potential conflicts with drug testing regulations.

More importantly, conventional physicians commonly overlook adrenal function. Restoring adrenal function is the key to recovery from OTS and involves evaluating adrenal hormone function, and undergoing a detailed adrenal support plan.

Understanding adrenal function is best accomplished through a saliva test; blood testing doesn’t give us the detailed information we need to accurately assess adrenal function.

5. Supportive Natural Medicines for Overtraining

Adrenal support involves supplying adequate and specific nutrients to the adrenal glands so they can continue to manufacture the two main hormones affected in OTS, cortisol and DHEA (dehydroepiandrosterone). The adrenal glands require support because the body’s stress response relies very heavily on production of cortisol and DHEA; after the body’s ability to tolerate stress has been exceeded, cortisol and DHEA production falls and contributes to many OTS symptoms.

Nutrient combinations like Adrenal B Complex provide the nutrients for adrenal hormone production.

DHEA can be used in small amounts to lessen the production burden of the adrenal glands. By adding an external source, the adrenals don’t have to work so hard to produce it. Think of this like getting an extra hand when you’re carrying a heavy object; it’s temporary and not meant for long term use. Used in this fashion, the adrenals can ‘rest’ and when the athlete feels recovered (and confirmed through repeat saliva testing), the DHEA supplementation can be safely withdrawn.

Similarly, herbal medicines like Rhodiola are excellent for supporting adrenal function. Rhodiola is an adaptogenic herb meaning it helps the body adapt to stress. Adaptogens are not stimulants, but rather exert nonspecific resistance to stressors.

Outside of adrenal support, other nutrients can be utilized to improve energy production within the cell’s mitochondria (the powerhouse of each cell). This is an important concept, as a fatigued person will often default to substances like sugar and caffeine for energy “production” but in actuality sugar and caffeine will only worsen adrenal function. L-Carnitine, CoEnzyme Q10 and Corvalen help the mitochondria create more ATP, or energy.

To summarize, overtraining syndrome can be difficult to diagnose, but should be a consideration in any athlete complaining of staleness, fatigue or depression that lasts more than a very short period (a few days) time.

Extensive rest, proper nutrition, and supporting the adrenal glands and cellular energy production are key components to overcoming overtraining syndrome.