Sports Performance

What’s measured

If you exercise regularly, this test package is for screening the effectiveness of your workouts and is designed just for you.

What will we test?

The Sports Performance Package includes the following tests: glucose, urea, ALT - alanine aminotransferase, AST - aspartate aminotransferase, GGT (or GMT in the reference literature) - gamma-glutamyltransferase, CK -creatine kinase, Ca - calcium, Na - sodium, K - potassium, Mg - magnesium, protein, bilirubin, testosterone, creatinin and ferritin.

Glucose (popularly called blood sugar)

Is a simple carbohydrate and the main source of energy for cells. In diabetes mellitus, glucose cannot get into the cells (and they starve). Blood glucose levels (increase, decrease) are affected by several hormones. This parameter should also be monitored in older athletes, who may be more sensitive to stress caused by physical exertion and related changes.

Urea

Urea is a by-product of metabolism. Its level in the blood is influenced by protein metabolism and the proper functioning of the liver (in which it is produced) and kidneys (in which approximately 90% of it is excreted in the urine). A small amount of urea (about 10 %) is excreted through the digestive system and the skin. Physical exertion automatically stimulates higher urea binding and excretion. A short-term increase in urea indicates that the human body is subjected to greater stress. This means that if the urea level returns to normal in a short period of time, the body does not go through any extreme conditions.

Creatinine - only in variant BASIC

Changes in creatinine levels are caused by age, sex, diet, muscle metabolism or kidney function. The rate of its production is relatively stable and depends on your muscle mass. Blood creatinine levels are also measured to detect possible kidney damage.

ALT

ALT (alanine aminotransferase) is an enzyme found inside the cells (in the cytoplasm) of many tissues. It is not only important for the formation and breakdown of amino acids and related nitrogen metabolism, but also plays a role in glucose metabolism. An increase in ALT may also be a response of the liver to the stress induced by intense physical activity.

Calcium

Calcium is a mineral and an essential building block of bones and teeth. It supports the functioning of many enzymes, clotting, muscle function (contraction and relaxation) and hormone release. Calcium levels are another parameter that gives us a comprehensive view of calcium's role in metabolism.

AST

AST (aspartate aminotransferase) is an enzyme found in the cell cytoplasm (60%) and in the mitochondria (40%). Its highest activity is observed in the heart, liver and skeletal muscle. It is released into the bloodstream when cell integrity is compromised. If the AST/ALT ratio (De Ritis coefficient) is greater than 0.7, this indicates a severe disease (significant cell damage) in which a greater amount of AST is released from the mitochondria into the bloodstream.

GGT

GGT (or GMT in the reference literature) is gamma-glutamyltransferase, the enzyme with the highest concentration in the liver. If we observe a liver cell, the GGT enzyme is close to its surface (membrane) and is therefore one of the first enzymes to be released in the event of damage to the liver and bile duct (caused, for example, by drugs or alcohol).

Creatine Kinase - only in variant EXPERT

CK (creatine kinase) is an enzyme directly related to the ability of muscles to work. In order for muscles to function properly, they consume ATP known as "human gasoline". The higher the CK parameter, the clearer the cumulative effect of physical exertion and the importance of fatigue to your body. Adequate rest or modification (reduction) of physical exertion and aerobic oxygen metabolism is often sufficient to return to a normal state.

Sodium

Sodium is an essential mineral necessary for the normal progression of physiological processes in your body. It regulates the volume of fluids in the body and thus prevents dehydration during sports. Excessive amounts of sodium can cause blood pressure problems. Sodium is related to potassium metabolism, which contributes to the proper functioning of the body.

Potassium

Potassium (K) is an essential mineral closely related to sodium that regulates water volume and acid-base regulation in the body. Potassium is indispensable because physical exertion (especially with higher intensities) always induces high acid levels. When potassium is deficient, the ability of the muscles to function properly is reduced, so that intense physical activity is not possible. It is therefore essential for athletes to have optimal potassium levels.

Magnesium

Magnesium (Mg) is stored mainly in the bones and muscles, where it helps in the nerve transmission of stimuli, allowing people to feel constant or sudden mental or physical stress. It also supports enzyme activity. People with magnesium deficiency often experience general irritation and increased nervousness, potentially muscle cramps and chronic fatigue.

Proteins

Proteins are among the substances responsible for a number of important roles in the human body: they maintain pH, carry various substances, inform us about nutrients, provide us with immunity, participate in blood clotting, maintain blood pressure, and support chemical reactions in enzymes.

Testosterone - only in variant EXPERT

Testosterone is a steroid hormone produced in the testes. It is responsible for the development of primary (reproductive organs) and secondary sex characteristics, muscle and bone mass and typical male body hair, laryngeal growth (and associated voice changes), fertility, as well as male behavior and thinking. Small amounts of testosterone are also produced in women. In athletes, it is recommended to monitor testosterone levels regularly, as it responds to any kind of stress or strain.

Bilirubin

Bilirubin is a yellow-orange dye, a product of haem metabolism (haem proteins contain iron), and is found in red blood cells but also in many proteins (e.g. myoglobin, peroxidase, cytochromes). Bilirubin and its metabolites are produced daily in the spleen, liver, and bone marrow. They are responsible for the typical coloration of bile, stool and urine. Bilirubin levels can also be increased by excessive physical exertion, so bilirubin in athletes is monitored regularly.

Blood count with differential

This test can detect anaemia and the resulting impaired oxygen supply to tissues. In addition, it can rule out the risk of infection or immune system disorders, suspected blood clotting disorders, or the potential risk of blood clot formation. A blood count examination also includes a differential blood count.

Iron - only in variant BASIC

Iron is carried in a closed circuit in your body. Iron levels fluctuate throughout the day depending on the food you eat, the physical stress and strain, and potential diseases. Therefore, its diagnostic capacity is limited.

Instructions before collection

We do not recommend entry of patients/clients with clinical signs of disease (temperature, cough, signs of respiratory tract infection, etc.) to undergo this test.
We recommend hand disinfection prior to entry to the clinics/collection points.

It is advised to fast for a minimum of 8 hours by refraining from eating or drinking anything expect water. Faiing to fast before the test may affect result quality. If you are currently on medications, consult your healthcare provider to determine whether you should continue taking them prior to the test.

PREPARATION FOR BLOOD COLLECTION
The recommended time to collect blood is between 7 a.m. and 9 a.m., to obtain comparable results from different blood draws. To assess the numerical test result, so-called reference intervals are used, which are based on morning fasting collections and are used for population comparison. This time interval is also recommended in light of the biological cycles that naturally take place in the body.

GENERAL PRE-SAMPLING INSTRUCTIONS
It is necessary to come to the testing site earlier, so that you can rest in the waiting room for approximately 20 minutes to have a relatively relaxed body and mind.
It is not advisable to draw blood before collection.
It is necessary to arrive on an empty stomach for the collection itself, in the case of collections at a later time in the day, at least three hours on an empty stomach. At home, it is desirable to drink a sufficient amount of pure water (at least up to half a liter) - this is important for a successful blood collection. Mineral water, juice, coffee and tea are not recommended.
Herbs included in tea may contain substances affecting the blood count. Coffee and black tea increase gastric acid production and release insulin from the pancreas, thereby affecting glucose metabolism. Since everything in the body is interrelated, they can impact other tests. Another extreme is when your body is running out of fluids. In this case, the number of red blood cells, the level of protein and lipids bound to the protein increase and the level of urea in the blood can also increase. It is therefore advisable to drink pure water when you wake up.

Generally, it is recommended to:
• around 6 p.m. eat only light meals, do not eat fatty food (cheese, butter, cream, meat, smoked meat, bacon) and sweet meals,
• fast for 10-12 hours (Attention: it is not advisable to starve for more than 16 hours!), in the case of later collection (after 9:30 a.m.), a lighter breakfast is allowed, no later than 3 hours before collection,
• drink non-alcoholic beverages and drinks without sugar in the usual quantity, in the case of adult clients 24 hours before blood collection (Alcohol in the blood changes lipid levels, the level of glucose is reduced, uric acid levels increase and liver enzymes are released into the blood),
• take only prescribed medicines in the evening,
• avoid increased physical activity, and strength and endurance exercise the day before blood collection (Lipid, glucose, some enzyme levels in the blood and other parameters may change during physical activity. The recovery of normal values to maintain the accuracy of laboratory results may take a longer time, depending on the duration of the exercise, your physical fitness in general and other factors. We recommend maintaining normal daily physical activity such as light stretching, short cycling to work, gardening, etc.),
• avoid psychological stress, which raises blood glucose levels and causes the release of stress hormones in particular,
• avoid smoking for at least 6 hours prior to blood collection because it increases the level of carbonylhemoglobin produced by the reaction of the blood dye with carbon monoxide and alters the permeability and elasticity of the vessels, affecting the ratios of blood analytes,
• do not chew gum for at least 6 hours before blood collection, as this may affect glucose and enzyme levels,
• do not undergo stressful diagnostic or therapeutic interventions for at least 24 hours prior to blood collection.
If any of the tests you have selected require special preparation, you will be informed of the fact by email with the order and blood collection instructions attached. These specific instructions have priority over the general recommendations for preparation.

MEDICINES
It is recommended to have blood collected before the planned doses of medicines. If it is not possible to take the medicine later, you should inform the nurse during blood collection and specify what medication you have taken.
Take the medicines prescribed by your doctor in the morning or bring them with you to take them after blood collection (thyroid medicines, antihypertensive medicines, blood thinners, contraceptives, etc.) In the case of later collection (after 9:30 a.m.), you can take the prescribed medication in the morning.
Do not take iron, vitamin, nutritional supplements or other supplements, including homeopathics, for at least three (3) days prior to blood collection.

SPECIFIC SITUATIONS
In order to obtain the appropriate answers to your questions with regard to the laboratory tests, it is important to accurately notify the nurse at the healthcare provider about the following facts prior to your blood test:
• regularly used medicines and supplements (ideally come with a written list to the blood collection site),
infectious diseases you suffer from (e.g., HIV, hepatitis, mononucleosis...),
• contact with an infected person or presence in an infectious environment,
• if you have received an infusion within the last 5 days, specify into which limb,
• intramuscular injections within 3 days prior to the blood collection date,
• long-term immobilisation, lost ability to move,
• activities at higher altitudes,
• allergy to common band-aids,
• if you feel unwell when looking at blood or needles, please also notify our blood collection staff of the fact.

OTHER FACTORS
Please note that prolonged use of medication or other important factors may affect the values measured by the tests you have selected. For more information, please see the description of the specific test. To obtain objective test results, take the time to properly prepare for your blood collection.

Sources

[1] Ross R, Blair SN, Arena R, et al. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation 2016; 134:e653.

[2] Sallis R, Young DR, Tartof SY, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. Br J Sports Med 2021; 55:1099.

[3] Cunningham GB. Physical activity and its relationship with COVID-19 cases and deaths: Analysis of U.S. counties. J Sport Health Sci 2021; 10:570.