What Kind Of Damage Happens To Your Body After You Do A Hard Workout, Triathlon or Marathon?

Affiliate Disclosure

Articles, Fitness

Have you ever wondered what your body looks like on the inside after you do a hard workout, triathlon or marathon?

I decided to test it.

Here's how:

I did back-to-back triathlons on one of the world's toughest race courses (the Wildflower triathlon). This brutal protocol consisted of a Half-Ironman on the first day, followed by an Olympic distance triathlon less than 24 hours later.

Right before I hopped on a plane to California to head to the first triathlon, I went into my lab for a blood draw. My biomarker test weapon of choice in this case was a WellnessFX Performance Panel.

Approximately 40 hours after crossing the finish of the second race, I went straight back to the lab for an identical panel of bloodwork.

But that's not all.

I also used a special app called Sweetbeat to track my heart rate variability (HRV), which can be a key measurement of internal nervous system damage or overtraining. Specifically, I tested my HRV in the days leading up to the first race, immediately after the first race, and then the morning after the second race, and for several more days after that.

Finally, because it's already been proven that these type of extreme endurance events can elevate C-Reactive Protein (the primary marker for full body inflammation) by well over 250%, I decided to pull out every possible recovery method in my recovery bag o' tricks to see how much I could actually mitigate the inflammatory damage.

Ready for the results? Let's find out what happened (prepare to be shocked when you see my blood panel results) – and as usual, you can leave your questions below this post.


The “Pull-Out-All-The-Stops” Recovery Strategy

Before we get into the nitty-gritty blood work and heart rate variability data (which will probably shock you), let's take a look at how I actually performed during the race, the nutrition and gear I used in my attempts to mitigate the damage of back-to-back triathlons and how things panned out for race results.

Pre-Race “Damage Control”:

x2performanced-Ribose: In the seven days leading up to Wildflower, I loaded with d-Ribose, a potent ATP precursor. I knew my body would need to regenerate ATP from my available nucleotide pool as fast as possible between the two races. For anyone who wants to geek out on how loading with d-Ribose also allowed me to more easily tap into my body's own free fatty acids as a fuel, read neurosurgeon Jack Kruse's excellent article that reveals the truth about carbohydrates and exercise performance.

My “fuel of choice” for d-Ribose loading was X2Performance (they're aware I'm using their product and have offered you the code BENGREENFIELD to get $10 off a case of the stuff). I also slammed a shot of this immediately before the Half-Ironman, halfway through the bike, and on my way out onto the run.

Wild Plant Derivatives: I continued my daily use of wild plant derivatives, which are packed with natural antioxidants. I use these in my life on a daily basis to mitigate the damage from chlorine, toxins, pollutants, exercise, etc., but doubled up on both race days and also the day after the race. I get these in tiny portable packs called Lifeshotz, which I dump into my mouth and chase with a glass of water. My personal physician designed the stuff and I trust him.

Chinese Adaptogenic Herbs: For reasons you're going to find out about in just a moment when you see my blood work, I already had some serious cortisol damage control to do before either race even began. As you learn in my article about “digging yourself out of an overtraining hole”, adaptogens are the best way to naturally control cortisol, neural inflammation, and hormone imbalances. I normally use one packet TianChi a day, but doubled this up on the day before the race, the day of both races, and the day after both races.

Essential Amino Acids: I loaded with 10 grams of essential amino acids per day for the day before the race, race day 30 minutes before each race, and after both races. My weapon of choice in this case was Master Amino Acid Pattern (MAP), an amino acid supplement that is 99% utilized by the body to make protein. Compared to eating a steak, this is far less stressful on the digestive system to break down and absorb, and I didn't want to be making my gut work any harder than it had to.

Fuel During First Race:

In addition to the X2Performance listed above, I pretty much used the Pacific Elite Fitness Endurance Pack instructions to the letter. The Endurance Pack is something I personally designed to reduce gut distress, keep the body in maximum fat burning mode during a long workout or race, and reduce intake of high sugar and high caffeine compounds. It's basically comprised of 1) the MAP you already learned about; 2) a very slow release carbohydrate called “Superstarch” and 3) an ultra-concentrate of VESPA wasp extract.

All this stuff basically ensures you tap into your body's own fat while racing, you get stronger as the race gets longer, and you also aren't “tired and wired” the night after racing, which I've always found to be the case when using traditional gels, sports drinks, and bars. You can also read more about this fueling strategy in my Healthy Race Day Nutrition Protocol article, and leave your questions below.

Recovery Between Both Races:

20 minute cold bath, at about 55 degrees: Here's a good article I wrote about why icing and cold baths work for recovery. In addition, I wore my 110% Play Harder compression pants with ice packs, then took the ice packs out but kept the pants on the rest of the day, and slept in them.

Magnesium Lotion: I used a quarter size dab of topical magnesium lotion rubbed into both legs, both before each race, after each race, and before I went to bed at night. The stuff is basically like the traditional magnesium spray with a bunch of extras added in, like organic jojoba seed oil, olive squalane, organic coconut oil, organic shea butter, and MSM for enhanced tissue delivery. It also doesn't make your skin itch like regular magnesium spray does. Here’s why I slather my body with magnesium nearly every day, especially after hard workouts.

Electrostimulation unit (EMS): I propped my legs up on pillows and used a Compex EMS unit in “recovery” mode for 30 minutes after each race. EMS acts to pump inflammation and swelling out of the legs, without any massage therapist required.

Pulsed Electromagnetic Field Therapy (PEMF): PEMF is the hottest new therapeutic tool in natural medicine. A home unit can be held up against injuries to help them to heal faster, but as you learn in my article “How To Beat Insomnia“, you can also place one of these under your mattress to lull your brain waves into deep sleep while at the same time speeding up the patching of damaged “holes” in your cell walls. On the night of both races, I used a small, portable PEMF unit called an Earthpulse.

Injury Pack: To speed up healing and shut down inflammation, I used the Pacific Elite Fitness Injury Pack, which is comprised of 1) Capraflex and 2) Phenocane. CapraFlex contains is a blend of glucosamine and chondroiton from type II collagen, along with a blend of 17 different anti-inflammatory herbs, botanicals, minerals and enzymes. Phenocane is a natural anti-inflammatory and COX2 inhibitor that relieves pain and eliminates inflammation without inhibiting COX1 development like aspirin does or causing many of the liver and stomach problems that ibuprofen and Advil do. I popped 6 Capraflex and 8 Phenocane after each race.

I also get into the stuff above (as well as my bike and run racing and fueling set-up for both races) in way more detail in a series of special videos I have inside the upcoming, brand new BenGreenfieldFitness phone app. Stay tuned for the release of that app in just a few days.

Fuel During Second Race:

Olympic distance triathlon fueling is fairly simple and straightforward. I slammed one shot of X2Performance and 10 MAP immediately before the race, then simply took a 1 hour serving of the Endurance Pack, mixed it all together into one bottle and gulped it down during the bike. I ate nothing on the run.

And in case you were wondering, I did indeed indulge in a glass of red wine and a nice big plate of Pad Thai after finishing up that second race. But up until that point, I was simply eating easy-to-digest food – specifically a blend of Living Fuel Supergreens, mashed up avocados, raw almonds, cinnamon, and lots and lots of coconut water.


Race Results

I pushed relatively hard in both races, but think I subconsciously held back just a little bit – partially due to the fact that I was doing back-to-back events, and partially due to the shocking blood panel I'm about to reveal.

Despite the blood work you're about to see, the first race felt fantastic.

An even bigger surprise was that aside from the first two minutes of the swim (during which my body was asking me what the hell I was doing to it and why I hadn't just slept in) the second race also felt fantastic. As a matter of fact, my body performed like a well-oiled machine the entire weekend, and in particular, I posted some of the fastest swim and run splits on both days.

Ultimately, my goal was to have the fastest combined time of any participant who completed the back-to-back brutal experience (there were about 125 of us who were insane enough to try it).

I ended up 3rd.

For an early season “test” race, and the first time I've ever done back-to-back races like this, I'm happy with that result.


Blood Panel Results

OK, so now let's move on the the fun stuff: the blood work.

In my article “A Crash Course On Finding Out What Is Going On Inside Your Body“, you learn that one way to test your blood via a panel from a company called WellnessFX. This company is based out of San Francisco – but is able to test the blood markers of most people in the United States. They simply send you a special form, you bring it into your local lab, and a few days later, the results are e-mailed to you, along with a special chart to help you interpret the finding.

Here are my pre (and post) blood work results: 


If you have a savvy eye for reviewing and interpreting blood panels, then you may have noticed that right off the bat, before I even did the back-to-back triathlons, I was relatively “messed up”.

We're going to delve in and take a look inside my body. You should be aware that if you're a triathlete, Crossfitter, or any other “extreme” athlete, your panel probably looks pretty similar to mind. If you find yourself scratching your head and having extra questions as I go through this, you should know that on May 24, I'll be teaching a blood work panel workshop to my Inner Circle, and you may want to join in.

High Cortisol & Low Testosterone:

Cortisol is released in response to physical and mental stress on the body. Cortisol can also increase during times of starvation or caloric restriction – primarily because it increases blood sugar for energy through the breakdown of muscle. Cortisol has also been shown to decrease fat breakdown, which can potentially increase fat storage on the body. Excessive cortisol suppresses your immune system, making the body more susceptible to infection.

Of course, you're probably familiar with testosterone as the hormone that does just about everything cortisol doesn't – it enhances drive, allows for muscle repair and recovery, increases competitive drive, protects your heart, and keeps you young.

If you notice under the Thyroid section in the chart above, both my pre and post-race cortisol levels were absolutely through the roof. In a well-rested and recovered individual, I like to see a morning cortisol of around 5-10. But I was at 23.1 before the race and 23.7 after the race!

But that's not all. Equally concerning is the fact  that both my total and free testosterone were extremely low compared to what I like to see in active, young men. Generally, I look for 500-800, and my values were at 356. My free testosterone, the actual active, potent stuff, was also extremely low. So in a nutshell, I'm a ticking hormonal time bomb, and I find this incredibly disturbing.

In my case, the high cortisol and low testosterone values were likely due to an enormous amount of work stress from juggling multiple books, projects, websites and clients, combined with the daily physical stress of training and calorie restriction. This is a potent one-two combo that you tend to see in many “CEO's” or “overachievers”, and I am absolutely no exception. Based on this blood work, I have realized that if I were not using all the recovery methods I currently use, I would probably be in a deep state of adrenal fatigue (which I would estimate at least 50% of triathletes, Crossfitters, marathoners, etc. suffer from). Towards the end of this post, I'll outline my strategy for getting my cortisol under control and my testosterone back up, because if I don't take steps to fix these hormone issues, it will shorten my life and vastly increase my risk for chronic disease, heart attack, and complete burnout.

High TSH:

Thyroid-stimulating hormone (TSH) is made by a small gland in your brain called the pituitary and triggers your thyroid gland in your neck to produce thyroid hormones (triiodothyronine or T3, and thyroxine or T4), which are crucial for your body's use of energy (AKA your metabolism). Thyroid hormones give your brain feedback as to how much TSH to release. If for some reason your T3 isn't getting converted to active T4 (poor liver function), or you have a lot of thyroid “antibodies” circulating in your bloodstream (poor diet), or your cell receptors aren't very responsive to thyroid hormones (high stress), then your body just keeps on churning out more and more TSH to no effect – and eventually your thyroid “burns out” and you're stuck with hypothyroidism and a low metabolism for the rest of your life.

My TSH appears to have been rapidly climbing since I first started testing it, and was up to 5.54 before the race. To put things in perspective, a healthy TSH is about 0.5-2.0. I'm on my way to hypothyroidism unless I take steps to fix this.

This high TSH is likely due to three factors*: 1) my through-the-roof cortisol levels causing my cell thyroid receptors to be insensitive; 2) small intestinal bacterial overgrowth from gut “dysbiosis”; 3) caloric restriction. In my case, based on my testing and symptoms, it's likely a combination of all these factors, and I'll be outlining my strategies to test and fix this in my summary at the end of this post.

*I also realize there are those out there who would propose that my low carbohydrate diet is stripping my body of glucose, which is necessary for the conversion of T4 to T3 in the liver. But because the body can make glucose from both protein and fats, this is unlikely. It is more likely that this is due to the fact that calories elicit an insulin response. This then spikes leptin levels in the blood. Moderate, regular consumption of adequate calories spikes leptin frequently enough to help signal to the hypothalamus that the body is being fed. Without leptin, the hypothalamus does not tell the pituitary to produce sex hormones or TSH. In other words (as you'll see from my rock-bottom insulin levels below), the low TSH is probably not due to low carbohydrate intake as much as it is likely due to low overall calorie intake, period. My “normal” weight when I follow my appetite is 185-190 pounds. But for triathlon, I keep myself at 170-175 pounds. That means daily calorie restriction. In other words, I may need to fatten up or really step up consumption of nutrient-dense foods if I want to optimize health. Ahh…the delicate balance between health and performance…

High Apo-B:

You may be familiar with this as a “particle count”. Apolipoprotein B (ApoB) are the primary proteins attached to LDL cholesterol. And while LDL cholesterol is really not an issue at when it comes to cardiovascular disease risk, a high ApoB is definitely correlated with cardiovascular disease risk.  ApoB on the LDL particle acts as a “ligand” for LDL receptors in various cells throughout your body (i.e. less formally, ApoB “unlocks” the doors to your cells and delivers cholesterol to those cells).

My Apo-B is definitely elevated, and I actually tend to see APO-B levels elevated in nearly every active individual's blood panel that I see. Chris Kresser has an excellent article entitled “What Causes Elevated Particle Number“, and in that article, the 5 reasons are: elevated insulin with poor blood sugar control, poor thyroid function, a “leaky gut”, bacterial infection, and genetics. It is highly likely that a combination of poor thyroid function, a leaky gut, and bacterial imbalances in the digestive tract are all playing a role in my elevated Apo-B levels, but I also suspect that elevated Apo-B levels are also due to increased delivery of cholesterol to tissues in response to inflammatory damage from exercise.

Low Insulin:

My insulin levels are at rock bottom. Let's take a look:


While low insulin levels may seem like a good thing, I'm not convinced that I should be absolutely charmed with these low numbers, because insulin is actually a highly anabolic hormone that delivers energy to muscle tissue and allows for enhanced growth, repair and recovery. This is one of the reasons that eating after a workout can be very important for proper recovery – by boosting your post-workout insulin you enhance delivery of precious nutrients to muscle tissue. So somebody with constantly low insulin levels may not be able to recover or build muscle properly.

But high insulin levels can cause insulin insensitivity, skyrocketing blood sugar, and type II diabetes. Because I eat a very low carbohydrate diet (and as you can see, my fasted blood glucose is absolutely fantastic) this isn't really a worry for me. I suspect that my low insulin values are related to high cortisol, lots of training, and an overall low calorie intake (recall that my stable body weight is 185-190 pounds, but I keep myself at 170-175 pounds for racing).

Low Insulin Like Growth Factor:

Growth Hormone (GH) is a potent anti-aging and anabolic, muscle-building hormone. IGF-1, or Insulin-like Growth Factor-1, is stimulated by GH, and is an easier way to measure GH activity than to measure GH directly. Both these hormones are the main hormones responsible for cellular and muscle growth, and both support anabolic pathways that lead to enhanced repair and recovery.

As you can see, my IGF-1 is severely suppressed. This is likely due to the same reasons that my insulin is low, my testosterone is low and my cortisol is high: the triad of lifestyle stress, exercise stress and calorie restriction.

High Liver Enzymes:

Aspartate transaminase (AST) and alanine aminotransferase (ALT) are enzymes that found mostly in the liver, muscle, and heart cells. Since these enzymes are found in liver cells, they are released when the liver is damaged. Mild elevations may be due excess calorie intake (which causes fat to get stored in the liver), heavy use of pharmaceuticals and alcohol, or (which is most likely in my case) physical exertion. 

It's pretty typical to see these levels elevated if someone has has exercised on the day prior to a blood test, which I certainly did, so these levels are not extremely concerning, but do highlight the fact that anyone doing hard training should be very careful with the use of alcohol or pharmaceuticals. And yes, I should probably dial back the amount of wine I drink on the weekends.

Low Liver Enzymes:

Alkaline phosphatase (ALP) is also a liver enzyme. Alkaline phosphatase is secreted during processes that are normal for the body, such as bone growth and pregnancy, but another condition that stimulates secretion of alkaline phosphatase in the blood is injury and inflammation from physical exertion. Interestingly, my ALP is very low. A low level of ALP can be caused by a number of medical conditions, but as you're about to find out, I suspect that in my case, the low ALP is caused by by insufficient production of new red blood cells (anemia).

Low Red Blood Cells and Low Hemoglobin:

As you can see from the two charts below, my iron, my red blood cell count and my hemoglobin are all lower than what I like to see in endurance athletes. This is likely due to high red blood cell turnover from hard training.



As with the other variables above, I'll outline in just a moment what I plan on doing about this “borderline anemia”, but this is another value that is concerning to me, and may explain why I've noticed dark circles forming under my eyes for about the past two years.

High BUN:

BUN, or Blood Urea Nitrogen is a measurement of the amount of urea nitrogen in your blood. Nitrogen is formed when proteins from muscle or proteins from food break down into their amino acid “building blocks” and get metabolized to nitrogen in the liver. This value tends to be elevated in people who exercise frequently (muscle breakdown) or who are dehydrated. In my case, it likely the former. Similar to the elevated liver enzymes, this is an elevated value that didn't surprise me.

High Creatinine:

Similar to BUN, creatinine is also a waste product that is formed when muscle cells break down. Your kidneys excrete creatinine and therefore an elevated creatinine can certainly be a sign of kidney dysfunction, but in athletes is usually just a sign of everyday wear and tear. Considering that I've recently starting using 3g of creatine daily as a nootropic, these slightly elevated levels of creatinine did not surprise me and are not too concerning.

Low White Blood Cells:

Nearly all my immune system markers were borderline low – another common issue you tend to see in hard charging athletes, stressed individuals, or both. For example, take a look at my white blood cell count below.


This is just one example that my blood work revealed of across-the-board low immune system cells. This means that I'm particularly at risk for catching colds, flus or other foreign invaders. In my case, I haven't had the sniffles in nearly three years, but this low immunity brought on by lifestyle stress combined with hard and heavy training could certainly have been the reason I came down with a MRSA infection last year (in which I nearly lost my leg).

The Good Stuff:

Just for some happy times before we dig into inflammation, allow me to throw in a few high notes.

My HDL (good cholesterol) is through the roof.

My triglycerides (bad fats) are rock bottom.

My  minerals and electrolytes are extremely well balanced.

My alkalinity (CO2) is fantastic.

And take a look at the chart bleow. Vitamin B12, which is a crucial element for hundreds of metabolic reactions, tends to be very suppressed in most athletes, (especially vegan and vegetarian athletes). But check out my B12 (I'm going to blame Lifeshotz for this one, thank you very much).


High CRP:

OK, let's jump back into the carnage that is me. Here's a result that came as absolutely no surprise.

C-reactive protein (CRP) is a protein found in the blood, the levels of which rise in response to inflammation and muscle damage. Its physiological role is to bind the surface of dead or dying cells in order to activate a healing response.

It appears that I do a really good job controlling inflammation, as evidenced by my rock-bottom pre-race CRP values.

But check out what happened after the race:


Yes folks, that's nearly a seven-fold rise in inflammation. In other words, this type of brutal event creates a complete inflammatory firestorm in your body.

It's certainly no secret that doing something like I just described or doing a tough Crossfit workout, an endurance race, or a solid bout of weight training causes muscle and body damage. Study after study have proven this to be true (feel free to click here and read one of my favorite “geeked out” papers that shows you the nitty-gritty details on exercise and inflammation).

But here's the very interesting kicker: aside from the massive elevation in HS-CRP, my blood work barely changed – even after being exposed to this brutal protocol.

Probably because I beat my body up so badly during these events, I experienced a slight dip in testosterone and immune cells.

Probably because I ate like a pig after it was all over, I experienced a slight increase in insulin and Insulin-Like Growth Factor.

And for reasons I can't explain but am currently researching, my TSH mysteriously dropped after the races.

But possibly due to my geeked out recovery protocol, and possibly due to the fact that my body was so messed up going into this whole thing that there wasn't really much more damage to be done, this whole back-to-back triathlon thing didn't seem to do much other than cause a crapola of whole body inflammation (which research has shown typically clears up with a week or two).

Now before we get to the heart rate variability scores, and also my plan-of-action to fix my obviously messed up body, let's chat for just a moment about inflammation.


Is Inflammation Bad?

Don't get me wrong.

I'm not saying that you should avoid damaging your body, or that post-exercise inflammation is a bad thing. Research proves time-and-time again that extended exercise programs actually reduce markers of inflammation over the long-term. This is because some degree of inflammation is necessary if you want to get any actual benefit from your workout. Muscle growth (hypertrophy), increased cardiovascular endurance, better strength, higher work capacity and pretty much any benefit of exercise actually occurs because your body gets stronger and better able to handle the inflammatory response to workout.

So every time you recover, your body naturally rebuilds and gets more hardy for the next bout. Hit me and I get back up. Over and over again. Usually stronger.

The problem is that in the absence of proper recovery, round after round of this acute inflammation can eventually become chronic inflammation, and that is when lack of blood flow to tissue, poor mobility, and risk for chronic disease or serious injury set in.

So go back and read what I did in between and after both these races to mitigate inflammation. According to my blood work, that's at least one area of recovery that I'm doing a damn good job with, so I'd recommend you implement at least a few recovery techniques into your own training if you don't want to get bit by injury from chronic inflammation.

Alright, let's move on to what this whole thing did to my nervous system.


Heart Rate Variability (HRV)

Using a phone app, a compatible chest strap, and a phone adapter, I can easily collect HRV measurements with a 5-10 minute reading while I lie in bed each morning. This allows me to constantly asses the health of my nervous system – a key and often ignored component of brain and heart health.

The genius folks at SweetBeat, who you may remember from my podcast on understanding heart rate variability, were kind enough to delve into my HRV data, and here is what they had to say (alert, this is about to get a little “nerdy”, but if you want to understand HRV better, listen to this):

“This first chart shows your HRV around your back to back events. The first 12 days in the graph are from a random chunk of your data from early January of this year. 

You can see a downward trend of your HRV in the days leading up to the events.

Note also that your HRV dropped significantly the afternoon after your Half Ironman, though you did recover relatively well the next morning (which was after the Olympic triathlon) – and even more on the 2nd rest day, which says you have a robust and elastic nervous system.

But notice your HRV dropped considerably after the “easy” swim and bike you did in the recovery week after the race. Possibly you were not ready for that level of exercise. It went up again after weightlifting, and then fell again after the swim/bike/run – likely because you were using the same muscular and nervous system components you tapped into during the race.”


“SweetBeat also has a feature that plots your LF (low frequency) and HF (high frequency) power levels. This is important to track for a couple of reasons:

-Higher power in LF and HF represents greater flexibility and a very robust nervous system.

-Sedentary people have numbers in the low 100’s (100-300) or even lower, fit and active people are around 900 – 1800 and so on as fitness and health improve. You can see you have hit 13,000 with HF which says you have lots of rest and repair potential available.

-Tracking LF and HF together illustrates the balance in the nervous system. In general we want the two to be relatively close. When they are not, it may indicate that the body is in deeply rested state (HF is high) or in a stress state (LF is high).

Notice (below) on the days you measured high cortisol, your LF was higher than your HF, showing a stress response. In particular the day before the first race the difference is larger than the Tuesday after, though the LF power on both those days was similar and statistically higher than your usual LF number.”


“Finally note that in the past month, you've had a downward trend in both LF and HF power.”


 OK, OK – this is Ben talking again, and I realize that was a big chunk of geeked-out data, but the ultimate take-away message is this:

I've got a healthy and robust nervous system, probably because I do meditation and yoga…

…but my nervous system health has been gradually declining since January, likely due to ever-increasing stress…

…the first race put a huge hit on my nervous system, although I bounced back quickly…

…and if I want my nervous system to recover as fast as possible, I probably should not do as much swimming, cycling and running in the week after a race.


Plan Of Action (e.g. Pulling My Own Parachute)

So finally, here's the moment I know that many of you (especially my lovely wife and dear mother) have been waiting for. What exactly am I going to do about my messed up body? I help lots and lots of people with these kind of issues, and it appears I could be doing a much better job taking care of…me.

Well, I'm a practical, brass-tacks kind of guy, so below is my exact plan of action.

1) My Borderline Anemia

I need to step up consumption of iron-rich foods. I've let my red meat consumption fall by the wayside, and haven't had liver in months (liver is a potent source of highly absorbable iron). We've already started into more red meat consumption (I downed a steak the size of a small child last night) and I've got a big batch of liver on order from US Wellness Meats. In addition, I've started a daily liquid dose of Floradix, a potent and highly absorbable source of iron and ferritin that unlike most iron supplements, does not cause constipation. Finally, I'll continue dosing with X2Performance, because the ATP Disodium in it has been conclusively shown to elevate ATP levels in red blood cells and plasma.

2) My Low Immune Cell Count

This article from WellnessFX has some great data on how to support your immune system through natural methods. In my case, I've ordered high quality astragulus and echinachea tincture from Mountain Rose Herbs, and I'll be using these on a daily basis.

3) My High TSH + High ApoB

This is one that I'll need to dig into a bit more, so I am going to be testing for both Small Intestinal Bacterial Overgrowth (SIBO) with a Metametrix Dysbiosis Panel, and also testing with a more complete thyroid panel from WellnessFX that will include Free and Total T4, Free and Total T3, T3 uptake, Free Thyroxine Index, Reverse T3 and Thyroid Antibodies. This will allow me to get a better grasp of why TSH is high.

In the meantime, I've launched into daily use of iodine and selenium supplementation with this iodine tincture and selenium-packed, mold-free, in-the-shell Brazil nuts. I've also started into a potent oil of oregano for controlling bacterial overgrowth in the small intestine, and ordered “Sweetbreads” (yes, edible thyroid glands), from US Wellness Meats.

If it turns out that I do indeed have SIBO (which I suspect may be the case due to the fact that I tend to take an enormously large dump each morning, combined with lots of bloating and gas if I ever eat a significant amount of fermentable carbohydrate), the ketogenic diet I am switching to for the next 3 months will probably be enough to “starve off” the bacteria. In addition, I will be combining that ketogenic diet with this gut healing pack.

4) My Low Testosterone 

The Brazil nuts, liver and red meat will help tremendously with this, but I've decided that I should probably get back onto the herbal testosterone support formula I was taking when my testosterone was actually elevated. In my case, this would normally be a product called RenewMale, but they're currently out-of-stock, but I am going to use another very good herbal testosterone product made by fellow trainer Mike Mahler, called “Aggressive Strength”. The steps I'm taking to lower cortisol will also help to raise testosterone.

5) My Low Insulin and Low IGF-1

If I'm serious about getting elevating these numbers (and restoring proper thyroid function), then I need to eat more. Period. This is ultimately a health vs. performance decision: stay light for being fast, or fatten up for being healthy. In my case, I've already started adding extra calories (primarily in the form of calorie-dense coconut oil and coconut products) into my shakes, smoothies and workout nutrition, I must admit that I have already felt more energy – and a bit more sex drive too, interestingly.

6) My High Cortisol and Low Trending HRV Scores

I've already doubled up my use of TianChi, started into daily cold thermogenesis, added a complete rest day each week with very relaxing yoga, started into more deep breathing protocols and meditation. But that's not all it's going to take to save myself from completely stressing out my adrenals. I've also begun to vastly cut back on my work obligations – from article writing to taking on new coaching clients to saying “yes” to new projects. I'm also spending way more time with family, and simply “playing” and relaxing each day. And although I never was a high-strung-stressed-out-guy on the outside, I always had some amount of internal pressure. But I'm already noticing a tangible difference in the way I feel and the way I breathe each day. In other words, I'm letting a lot of steam out of this pressure cooker before it blows up.

Ultimately, this plan-of-action may simply be a band-aid to stop the bleeding until I decide to call it quits on training for a few weeks, a few months, or possibly an entire year off. But at this point, I've painted myself into a Ironman training for Ironman Canada, and until I simply call it quits for awhile, the strategy above is how I'll be mitigating the damage.

And who knows? As you're going to find out at the end of this article, I'm doing a special experiment in which I'll be tracking my biomarkers every single week for the next 12 weeks, and perhaps the steps I've outlined abovef will be enough.



I'll say again what I've said before: endurance sports can be unhealthy. Heck, this is what I am writing an entire book on right now: the delicate balance between health and performance.


You need look no further than my cortisol levels, TSH, insulin, testosterone, growth factor, creatinine, blood urea nitrogen, white blood cell count, and liver enzymes to see this to be true.

And heck – I actually take care of myself pretty darn well. I sleep 7-9 hours, eat a healthy diet, meditate, and avoid excessive training. Just imagine what someone who doesn't do all those things looks like.

But I'll be the first to admit that despite the healthy measures I take, I'm brutally beating my body up with the sport I've chosen (triathlon), and if you're reading this, you probably are too (Crossfitters – you don't get off that easy – I've seen hundreds of these blood panels and you have the same issues).


The Great Ketogenic Ironman Experiment

So what's next?

Like I mentioned, I'll be answering a ton of blood work questions and questions about this article, my blood work, and my personal recovery plan in a live, video Q&A for my Inner Circle on May 24. Replays will also be available to my members.

But I've got even bigger news than that.

For the next 12 weeks, I am going back into “experimental guinea pig mode” for Ironman Canada in Whistler on August 25 – in what I am calling the “Ketogenic Ironman Experiment”.

Here's how it will work:

I'll be implementing a 100% ketogenic diet, along with:

-weekly Talking20 blood measurements

-daily Metron breath ketone measurements (e-mail Dan Bourbonnais [email protected] if you have questions about this).

-daily Sweetbeat HRV measurements

Hypoxico's Intermittent Hypoxic Training protocols

Jay Schroeder's EVOAthlete electrostimulation, isometric and overspeed training protocols

-All the other “underground training methods” I outline in this article.

I'll be presenting the results of the experiment at this year's Ancestral Health Symposium during my panel with Jimmy Moore, Robb Wolf, Mark Sisson, and Jamie Scott. And that will be exactly one week before I take things into the trenches and try to qualify for Kona at Ironman Canada.

For those of you interested in the full nitty-gritty details of this Ketogenic Ironman experiment, I'll be posting regular video updates on my diet, my blood testing results, my training and more to the brand new BenGreenfieldFitness Android and iPhone app when it gets released in just a few days. I'll also be keeping you up-to-date on how my personal recovery plan outlined above is actually affecting my biomarkers.

Stay tuned for more on that new app and the killer content inside it. It's really going to blow you out of the water.

But in the meantime, leave your questions, comments and feedback below – although I'm sure you don't have any after this super quick and short blog post…right? 

Ask Ben a Podcast Question

96 thoughts on “What Kind Of Damage Happens To Your Body After You Do A Hard Workout, Triathlon or Marathon?

  1. It is July 2016 and I found this article so interesting after just finishing my first indoor sprint triathlon (woo hoo). I have a condition called Lipedema, stage 3 possibly going into stage 4. Because it went so long not being properly diagnosed I also have Lymphedema – lots of inflammation. I wanted to see how a healthy (non Lipedema) body recovered from a triathlon, so I could compare it to my recovery (which seems to have happened quickly, given a few sore muscles, sore feet, but nothing like my 5K recoveries from a couple years ago). I was not expecting such amazing detail like you provided here, more looking for typical days needed to recover, what aches and pains to expect, etc. so I could write up a comparison to what I was experiencing for my Lipedema fitness support group. Exercising itself is controversial in the Lipedema world, thankfully one the doctors are not advising against any more (which is what I was told in 2007 when initially diagnosed, that exercise would make my condition worse – think because the fear of inflammation post hard workouts). They still try to tell us our muscles are weaker, etc. no heavy lifting, etc. but I don’t see that in my training (I’m getting stronger even as my condition progresses). I would love to have some blood work testing in Lipedema patients in a fitness based analysis, but most doctors and medical professionals look at us as just obese, and write us off. Thank you for your valuable info. It has given more desire to keep looking, and keep training.

  2. delsolvtec says:

    Dude……nice detailed analysis……however, a kind message:

    1. excess supplementation will stress your liver and kidneys ( you can NEVER be sure what other chemicals are in your supplements)

    I would think, looking through your column…thats all you need are the following:
    1. REST, SLEEP – it will bring your cortisol down, increase your insulin, testosterone levels and reduce your TSH
    ( when I say rest and sleep….for you, I think a 3 month layoff cos you are obviously overtrained by a long way )
    2. Eat natural – healthy meats, eggs, veges, fruits, healthy oils, liver is good too
    3. Focus on your events that are important to you – you cant be hammering your body away at every event. Extreme fitness does not equate to extreme health. Its not a linear relationship.

    so please, stop torturing your body, you will live longer for that.

    No amount of supplementation will help you if you dont do the basics well…..get enough REST, SLEEP, RECOVERY TIME.

    1. Actually I just finished a book acknowledging the paradox between extreme fitness and health (http://www.beyondtrainingbook.com). I delve into this entire concept you’re outlining here.

  3. Mitchell says:

    Great article Ben. I'm 45 years old, train under a great coach, complete IM's, and eat well (I think) but I cannot get rid of my belly fat. The rest of my body can be pretty ripped, but I always have this little (sometimes bigger) spare tire. I'm going to be in CA next week (we don't have WellnessFX in MN) and would like to get tested. What test would you recommend to help get to the bottom of this? Thanks!

    1. The "Performance" one, Mitchell. You can get it here: http://pacificfit.net/items/performance-test/

  4. cogrick2 says:

    I admire your courage and openness, Ben. It's really a service to us all – posting these results. Many questions have come to mind as I have thought about this post over the last few days. A few, please:
    (1) Do you worry about Vitamin A toxicity from the liver you will be eating? I saw the concern expressed on Wikipedia.
    (2) Have you heard of athletes going ketogenic while eating more and increasing insulin and IGF-1? I am curious of whether enough glucose will be produced from your proteins and fat to stimulate these compounds as you hope.
    (3) Are you working with anyone, like a physician or fellow biohacker? I hope you will. Doctor Kruse made all of us appropriately nervous about your health.

    1. Considering I am having a sane portion of liver once a week, I am definitely not concerned about Vitamin A overload. I have seen no evidence that ketosis can increase insulin and IGF-1, but remember – protein can cause just as high an insulin release as carbs. I also have many, many physician "advisers" who I talk with regularly! So I'm definitely not going this alone!

      1. cogrick2 says:

        Thanks for the good news. I did not word question 2 well. I wondered why you were confident that eating more despite eating low-carb would increase insulin and IGF-1. I understand now (protein -> insulin). As for the liver: I have been eating U.S. Wellness Meats liver products (liverwurst and braunschweiger) daily for the last couple weeks. Concern should be greater for my consumption, I see, than yours! You inspired me to keep a much sloppier log of my notes as I work towards understanding my lab results (cogrick2.wordpress.com). High SHBG lowering my free T and some similar concerns as you about iron-related components.

        1. Best of luck. Keep me posted.

  5. Pon says:


    I've been using UCAN, but experiencing some really bad post long run/race gas. What's the cause of this? I know it's UCAN because for the past two days I stopped using it and exclusively used cocochia and vespa for fueling. No post race gas issues.

    1. Small Intestine Bacterial Overgrowth may be aggravating this. Check out http://www.siboinfo.net. You may have a leaky gut too…we'd have to dig a little bit on this…

      1. Pon says:

        Thanks for the response Ben. The page doesn't appear to work http://www.siboinfo.net/. What should I do to figure this all out? I'm training for a 100 miler and don't want to die of major bloating and gas issues.

  6. Tom says:

    Another question I'm afraid. I have been experimenting with cold baths, more for cold water acclimatisation (for open water triathlon, with low body fat I always struggle) than thermogenesis.
    I have a race monday that promises to be in a very cold river, would you suggest a cold bath a few hours before the race on monday, to fire up the brown adipose tissue and keep me warm for the race?


    1. It can be pretty energetically demanding to warm yourself back up. I've found myself "drained" for hard workouts/races if I do them after a long or very cold thermogenesis session. I'm a bigger fan of just 5-10 minutes of hot cold contrast in the shower, and then put on some embrocation cream.

      1. Tom says:

        Thank you Ben, thats just the answer I was after! I will dedicate the win to you tomorrow ;)

  7. Phil says:

    Looking at the labs, it looks to me as if WellnessFx has transposed the HDL and Triglyceride levels. Since I don't know your lab history, I can't say for sure. However, the HDL would be one of the highest I have ever seen as well as the TG being one of the lowest I have ever seen. If they were switched, they would be much closer to what I would expect to see.

  8. Tom says:

    Hi Ben, quick question about your HRV. I monitor my HRV daily and have noticed some interesting trends in the VLF component, have you ever looked into this? I do full spectral analysis with a program called Kubios, does sweetbeat tell you the VLF or just the HF/LF?

    1. I'm going to ask Sweetbeat about this and get back to you ASAP, Tom.

      1. Tom says:

        Cool, thanks mate.
        some days I have a very very high VLF. say up to 80% of the power. Research is unsure what this means but could be related to diet, stress etc.
        I have noted that if I take serial readings across a morning I am fasting, till 12 noon usually, VLF gets steadily higher until I eat. It also seems to be higher when I am ketogenic, so could be of interest to you.

        Also, in regards to your Ketogenic experiment, I take my ketone readings with a blood monitor multiple times a day, I have found from my research that I can consume huge amounts of carbs in and around training (mostly in the form of waxy maise starch) and sweet potato, and still be ketongenic (ketones 1.5-2mmol) the next morning. But If I overdo it on protein and fat later on in the evening and eat my last meal later than say 8.30 pm I have no ketones the next day, down to 0.3 or similar. Food for thought.

        1. Very interesting. You ever try consuming bitter melon extract about 30 minutes prior to that evening meal?

          1. Tom says:

            I haven't no, its a tad harder to find over here. Can you link me to the one you take please so I can chase up that one.
            Thanks Ben,

        2. They said: Kubios is freeware. From the back end of SweetBeat you can export the RR Intervals and plug them into Kubios. This will give you VLF and the other side of HF, too. But for now SweetBeat only shows LF and HF. We have talked about giving professionals the export option in the future.

          1. Tom says:

            Cool thanks Ben. The significance of VLF is still up for debate. I've read many theories including infection (this one I have noted in myself, I have predicted my last 3 infections with a sudden surge in VLF noted 2-3 days prior to symptoms).
            Also there is evidence it is linked to energy expenditure, which could be highly linked to the thermogenic and energy burning effects of MCT/ketogenesis. Such as –

            This correlates well with my findings in ketogenesis.

  9. Evelyn_CarbSane says:

    It makes me absolutely cringe to read misinformation like this:

    "'high insulin levels can cause insulin insensitivity, skyrocketing blood sugar, and type II diabetes"

    Have you ever had an OGTT with insulin measured?

    1. Not yet, Evelyn. Why do you ask?

      1. Evelyn_CarbSane says:

        I ask because the insulin you are interested in is the postprandial response — the insulin that will partition fuel into your lean tissue for building and repair. I don't think the low basal insulin is anything at all to be concerned about — it's quite "normal" for someone like you — lean and engaging in endurance activities — to have exquisite insulin sensitivity coupled with low fat mass and thus not much need for insulin in the fasted state. I'd be concerned if your FBG was elevated as that would signal insulin deficiency, but that is not an issue.

        So if you're concerned at all about insulin impacting anabolic processes it's your postprandial response that you're interested in, hence the OGTT suggestion to measure that.

  10. Jordan says:

    Maybe the concluding line about pressure cookers blowing up is a little macabre given recent events? Am I the only one that noticed that?

  11. IvanDrago says:

    Hey Ben,

    I have been following your blog for over a year now and, for me, it is the most comprehensive and provided me with the most useful, applicable information I have seen online related to fitness.

    I felt like I had no choice but to comment after reading this entry. I am a competitive soccer player who has been to injury hell and back (more than one failed surgical procedure for chronic exertional compartment syndrome) and have used the information on your blog to embark upon a comeback that at one point seemed impossible. After reading this entry and having drawn labs after my first season back from injury, I understand why so many professional players retire at approximately thirty years of age. My labs reflect a mirror image of your own! I can't speak to how you feel, but I felt physically and mentally destroyed after that season ended in November.

    What you are doing here is compelling, and if you can conclusively prove that you can compete and retain healthy labs (namely testosterone), then I think you will have done something very, very significant for endurance athletics. I am hoping that you can.

    If you or anybody else is interested, an extended version of my story and some of my labs can be found on Dr. Kruse's website on the forum. I go by the username IvanDrago.

    1. Very interesting, IvanDrago….I will have to go hunt down your story on Jack's site!

    2. delsolvtec says:

      What healthy labs?

      His testosterone: cortisol ratio is terrible.

      His TSH is high cos his thyroid gland is running constantly at full speed.

      His pancreas is non-existent

      He is anemic

      His CRP is high.

      All the markers for an inflammatory state of the body which will eventually lead to hepatic, renal and cardiac malfunction.

      This is not how evolution intended the body to function.

  12. Rick says:

    Ben I was a hardcore triathlete for 20 yrs and hit age 50 with a blood panel that looked remarkably similar to yours except for the cortisol which thanks to adrenal failure had crashed and stayed low all day. Good news is that you can recover, but the hardcore training has to go. Find a good naturopath to get those hormones tuned up and follow some of Dr. Kruse's protocols to get back on track

  13. Jesse says:

    super detailed and intense breakdown.

    i wonder what my blood work looked like?
    i did the big sur marathon the weekend before prior to the W squared events.

  14. Kelly says:

    Ben, could you give a little more info on your cholestrol numbers? As you say, your HDL and triyglicerides are great. Donyou think your higher LDL is a result of inflammation primarily or are there dietary factors as well. I know you're a fan of the PHD and I am moving that way as well. But I'm curios if you feel the high fat profilr of that diet contributes at all to elevated cholesterol. Thanks for sharing and continually investigating for the benefit of everyone else.

    1. My higher cholesterol is simply because I eat a very high fat diet. Remember – I dont care about elevated cholesterol. No link between that and heart disease. What's important is cholesterol particle size and number…

      1. Kelly says:

        Ah, yes. Particle size. Very good. Thanks so much for the clarification. And, again, thanks for all the wonderful information you provide. You have made my me and my family so much healtheir.

  15. Jenny says:

    Awesome info, Ben! Thank you for providing so much education. I, for one, have learned a lot from you. You mentioned that you meditate. What method do you follow and for how long each day? Thank you.

    1. Deep nasal breathing and yoga for 10 minutes every morning, and then one more intensive 60 minute-ish yoga session each week.

  16. Tom says:

    quick comment on your use of ketone breath analyser to monitor ketosis, does this not suffer from the same problem as the ketostix? As the ketostix are measuring acetoacetone and the breath meter has to be only measuring acetone expired by the lungs? Will you be coming this with blood testing for beta-hydroxybutyric acid?

    1. Metron says: The answer to the question is that ALL of the comparison testing we have done with Metron is against BHB in blood…we have the studies to back this up. We do not even consider Ketostix to be a comparable test to Metron as the Kidney keto adapts itself over a 3-4 week period once a person starts a ketogenic protocol, and as a result Ketostix tests can turn up a lot of false positive or negative results.

      The Metron test performs very consistently for those that are just commencing a ketogenic program as well as those that have been doing it for a long period of time.

  17. Tony says:

    Hi Ben, awesome write up, going to take me a while to digest it! Just a quick note to say the link to the ketone breath meter doesn't appear to work. Thanks.

  18. Neil Martin says:

    Great article Ben. I'm really interested to see how your diet/supplement/lifestyle changes affect the numbers. I've also signed up for Talking20, but I'm also wondering about having the WellnessFX panel done as well. It looks like those are more comprehensive at this point, although I do know that Talking20 will be expanding their list of tests. How much does the WellnessFX tests cost?

  19. Dan Ordoins says:

    Nice post Ben…. I hear that Jack Kruse may be commenting on your blog post here soon… Looking forward to that as well as I have been working on a keto syle diet and lifestyle working on the PPP pathway for performance and health…. Just over a year or so in it for adaption….

  20. Dan Ordoins says:

    Nice post Ben…. I hear that Jack Kruse may be commenting on your blog post here soon… Looking forward to that as well as I have been working on a keto syle diet and lifestyle working on the PPP pathway for performance and health…. Just over a year or so in it for adaption….

    Keep up the good work!


  21. jackkruse says:

    When you run out of stem cells you get to CS. This is another way to say you are aging like mad because your molecular clocks are on a fast forward pace. Senescent cells display all the classic signs of aging and telomere shortening was once hailed as the central cause. Unfortunately, the telomere shortening theory has recently fallen apart when other causes of CS were discovered that were independent of telomere length. But what you are doing to you is undeniable based upon what we do know today…….and your labs are trying to tell you. They are your Rosetta Stone………they are like a surgeon whispering in your ear what your doing but the key point is……….are you, BG listening? You IGF 1 is a big tell. I can imagine what your ASI and salivary melatonin look like. In brain Gut 11 I lay out what they mean. Cancer and aging is where it leads. Although there are major differences between aging and cancer, they both end up on the same “dead end” street for humans. From a proliferative point of view, they are clearly opposites when you study the quantum and molecular effects. There are 6 major hallmarks of aging and cancer that we know of today. You are exhibiting every last one of them in you panel and your shared experience of your behaviors on social media. I will be delving into this complex quantum dance of aging and cancer soon enough. Maybe sooner because of this blog. There is so much more detail I could go on for days……..Aging and cancer exhibit epigenetic silencing of genes that should NOT be silenced. There does not have to be any damage to DNA to generate cancer when you understand this dance. 50% of human genes that are consider house keeping genes that are tissue specific are the genes you are putting at risk. When inflammation is sustained long enough the changes to your chromatin and euchromatin becomes exactly like a point mutation in the DNA from radiation or bad heredity that can cause cancer. With exercise induced aging or regular aging, many genes are silenced this way without any mutation of the DNA. One such gene is the BRCA1 gene Jolie made famous this week. Amputating your organs makes no sense when you understand the real dirt on this science. She will learn that as she ages way faster from this point onward. Ironically, your maintained B12 tells me a lot about your reserve……..you’re still OK……..this is a proxy for your ability to still methylate well and is a good sign for your DNA. But how long will this be the case with the things you want to do? Doing an Ironman with these labs and this story is akin to playing Russian Roulette. I hope your family talks to you and you listen to that little voice in your head………but if you dont my advice is to your family…….buy term insurance for Ben and become the beneficiary. I hope BG you solve this problem for you. I love that you are challenging your own dogma and testing………but you labs are telling ya something. Something big. “By letting it go it all gets done. The world is won by those who let it go. But when you try and try. The world is beyond winning.” Lao Tzu

    1. I *do* have a 4 million dollar whole life policy on myself. And it was primarily because I ride my bike fast down hills. Now I'm seeing that there are other reasons to carry it too. This is why I test Jack, and your words are certainly something I take to heart. Lots to think about.

  22. jackkruse says:

    BG you are a poster child for my theories on my blog……..there is a whole lot more to your labs. The TSH thing is easy…..read the hormone 101 blog post (http://www.jackkruse.com/hormone-cascade-101/) . CRH is a direct TSH and T3 competitive inhibitor……and it explains your IGF1, testosterone…….why is your WBC's crashing too? DHEA is crashing…….I wrote an entire blog about this on 6/3/2012 ( http://www.jackkruse.com/hormone-cpc-1-dhea/) Ben everything you poster here I told the people at Paleo Fx 2011, …….and they laughed, especially the young paleo crossfitters. Post Paleo Fx then one approached me, and only one of their posse, took up my challenge to test…….themselves. He found what you did too. He wrote a guest blog post on it called http://www.jackkruse.com/cold-thermogenesis-11-pa…. The moral here………when you understand how our species is designed the results are quite predictable. The issue…….our beliefs block us from ultimate truths. When you are an endurance athlete you suffer with CHRONIC pregnenolone steal syndrome. Then when you do something like you did here you add a new layer of stress to the system and you cause an acute pregnenolone steal on top a chronic one……..and the result is a stimulation of the CNS at the PVN via the autonomic nervous system to counter balance the damage. This is why the labs rebounded. I have a blog for that too; http://www.jackkruse.com/brain-gut-16-adrenal-fat…. The kicker for you and your readers that I also shared with the crew in Austin as they laughed……..this is an iceberg story. You only know about the short term hormonal and blood results………the real problem is the chronic damage you just did to your telomeres. You likely uncapped them and I bet you would not like what testing on them would reveal when you marry it with other testing you probably dont know about. The very recent discovery that chromosomes have non-coding DNA “caps” called telomeres at their ends and that telomeres shorten with cell division led to the theory that telomeres were like an “aging clock” with a finite number of ticks on the clock. I told the people in Austin this 2 yrs ago. The study of telomere shortening led to the discovery of another phenomena called cellular senescence (CS). You my friend are blowing thru your supply of stem cells every day your alive with this behavior. You are depleting your life force.

    1. I couldn't agree more Jack (and I have read EVERYTHING you've written, BTW). I hope that by releasing these labs people realize that even guys like me have lots of biological leaks that need addressing. Thanks for everything you're doing to educate us on this matter. I've never thought that Ironman triathlon extended your life. I am in the interesting position that A) I love triathlon and B) the triathlon market is how I feed my family. Ultimately, I'm still learning the paradox between health and performance and I *think* you can still do this sport and be healthy…but it remains to be proven. That's my next step.

    2. kate says:

      I so wanted Jack's thoughts on these labs! Time to go reread all of these blogs he linked to. Its hard to hear this when you love running, but want longevity. Ben I will so curious to see how you proceed. It frightens me to think of what's going on in my own body if this is happening in yours. It seems you have done so much (more than myself and just about every athlete out there) to mitigate so much of the damage so I am surprised a bit by all of this! When your identity, livelihood, passion and career revolve around this sport, hard to let it go!

      1. Let's put it this way: I am making MASSIVE changes in my business, my life and even my diet. Stay tuned for more on that.

        1. kate says:

          As a Superhuman Coach, I'm looking forward to the changes and learning even more from you! I have always respected the way you do things and feel I am in the same place of changing course. No one said it was going to be easy, but I think it's time!!! We must remember that there is a reason for it all….beyond the health aspect!!

  23. Megan says:

    This was awesome. Thanks for posting!

  24. Megan says:

    This was awesome. Thank you for posting!

  25. Danny J Albers says:

    Stepping back from the trees and looking at the forest, how concerning is this really?

    Seems to me our bodies react to extreme stress, and then bounce back stronger. As you point out this happens to Cross Fitters, it also happens to body builders, boxers, etc…

    Unlike someone sedentary who gets these tests, here we know the cause, and its known effect…

    Sure, the larger the immediate stress, the greater the immediate danger, but once that has passed…

    It is said a bone never breaks twice in the same place ;)

    1. I'm actually concerned about how my labs looked BEFORE I even started Danny!

  26. Alan says:

    Thanks Ben for such an insightful article – I'm convinced the combination of a stressful job plus the inflammatory response caused by my love of running and triathlon is spiking my cortisol levels and other hormonal imbalances despite sensible and healthy diet etc. maybe we all need to rest more a la "Primal lifestyle" and play sensibly instead of calling marathon running and IM playtime!!

  27. Bob says:

    Ben, did my first 50 miler back on April 13, then the season's first tri (olympic distance) on May 5th. I can't seem to shake the achiness that typically resolves itself within a couple days of the event. I've been taking it easy, but have a half-iron distance event in later June, so I can't deviate too far from the plan. I had blood drawn for testing yesterday, and am awaiting results. Any thoughts on what my body needs or is craving?

    1. I'd look into Iron, Vitamin C, proteolytic enzymes and amino acids…

  28. Tom says:

    Thanks Ben, as I say I have been conducting my own Ketogenic experiment. I have been getting as much coconut in a possible, now combined with MCT oil.
    I have avoided all carbs for a while, including starches, but have decided to add them back in due to the worries of cortisol and testosterone.
    Interesting I had a big carb load after a road race last night, but with a bit of MCT oil this morning my ketones are actually higher!

    I tend to find from blood testing that it is protein overload that affects my ketosis more than carbs. I when to an all you can eat Brazilian steakhouse last week, after eating shed loads of meat it took me 3 days to get back into ketosis!

    One of the other issues I am having is related to this
    I intermittent fast, I don't eat till about 12 noon and generally eat 1-2 meals a day. This is just how I work, I don't do it on purpose I just don't feel hungry in the morning. Therefore I am having an issue with having protein loads in big amounts at Lunch and Dinner, this is badly affecting my ketosis.

    Do you think I should try and eat breakfast so I can balance my protein better?

    1. Yes, but do high fat coffee for breakfast, like bulletproof coffee with butter and mct oil, so you stay in a state of ketosis….

  29. Hemming says:

    Very comprehensive and impressive article! I'm very much looking forward to the ketogenic 'experiment'.

    Is there any significant difference between coconut oil and creamed coconut, besides for the protein and carb content of creamed coconut? I'm trying to gain weight from anorexia, repair my entire body which is in very poor shape and get some energy as I'm lethargic as hell all the time.

    Keep up the good work!


  30. Alex says:

    Very interesting to see these results. I just had a few points to make:

    1. Multiple testing and normal ranges.
    The blood panel you had done is very extensive with >50 individual tests. The normal ranges are defined statistically and so if you do many tests, there is a good likelihood that some will be 'abnormal' simply by chance. Therefore some of your 'one-off' abnormal results e.g. TSH or testosterone are probably simply false positives and no cause for concern.

    2. Most of the results you say are abnormal are actually normal!

    Your haemoglobin and white cells are all normal. Whilst your iron levels are very slightly low (probably randomly), your ferritin (which is a much better test of iron reserves) is normal. Your insulin is normal. Your cortisol is slightly elevated, but only slightly and is probably adaptive in an athlete.

    3. Your CRP after the races was surprisingly low! I do think calling it an 'inflammatory firestorm' might be a bit excessive… Most labs in the UK classify a normal CRP as <5. CRP in infections or inflammatory diseases is often >100.

    4. The plan of action you have made isn't really necessary!

    A. You are not anaemic and you have a normal ferritin and iron binding capacity. More iron will therefore simply be excreted.

    B. Your white cells are normal. Therefore no treatment (not that it would work!) is necessary

    C. Only one TSH result is slightly outside normal range. It is therefore unlikely to be significant. Eating iodine containing supplements is not indicated and in fact may create false positives in the tests you are doing.

    D. Your testosterone was only low in one measurement and is not likely to be relevant

    E. The slightly high cortisol is probably adaptive to your training. Cortisol levels also vary during the day and should be measured at 9am to use the reference range.

    Anyway, I agree that it was surprising just how little anything changed and I certainly don't think you are a 'ticking timebomb'. Good luck!

    1. Simon W-S says:

      What a calm, considered and very British response! It sounds like the gist of this retort is "we're all a tiny bit messed up, carry on as you were…"

    2. Alex…but isn't this the difference between being "not sick" and being "performance worthy"? I'm not trying to avoid dying as much as I am wanting to optimize everything for ideal performance.

  31. jackie says:

    wow, what an awesome post! thanks so much! i have a few questions for you – what's the difference between apo B and LDL particle size? also, do you take vitamin D3? if so, how much? or do you just get your vit D from the sun? (i have vitamin D envy :-) my level is pretty low). and finally, i'm trying to decide whether to get a sweetbeat or a tinke. it seems like you use your sweetbeat more? is it more accurate?


    1. Read that article I linked to in the post to Chris Kresser's article on particle number Jackie. Also, I take Lifeshotz daily. It has 1000IU of D in it…

      1. jackie says:

        that's it? only 1000 IU a day of vit D? wow, you must have good vit D receptors. i was taking like 4000 IU a day and still am on the very low side of normal, in the 30s. i just read that stress and chronically high cortisol can deactivate vit D receptors.
        i did also read chris's article, but it didn't talk about apo B. i just got my blood test results yesterday and my lipid profile was fine except high LDL particle number (1431). from what he says, high LDL particle number could be caused by infection, messed up thyroid, or gut issues, and i have all 3 of those.

        1. Remember….I eat a very high fat diet. Fat soluble vitamins are not an issue for me.

    2. Oh, and I use the Sweetbeat more than the Tinke because it gives me more data…

      1. jackie says:


  32. Julia says:

    This kind of shocks me 'cause I always think of you as the dude that takes care of himself. I can't imagine what the average Joe triathlete's (or athlete's) blood panel looks like.

  33. shirley king says:

    I am battling bronchitis and asthma right now before a half ironman race on june 8th. Have cut down on training and hope i can still do it. It seems winter training has no health issues but as soon as i get close to racing season, my asthma kicks in.
    I am 66 years old and love this sport but i have trouble balancing training and rest, my nutrition is pretty good but wondering where to make changes and how to analyze myself.

  34. Caroline says:

    WoW,.Brilliant article, you're an inspiration. But go spend some time with your family!!!! I'm off to deadlift!

  35. Matilda says:

    Hi Ben,
    I have high cortisol, have suffered some adrenals fatigue but trying to push on the best I can with racing in the pro ranks.

    Just wondering as a female, would we won't 2b raising our testosterone levels to also combat a dominance in cortisol?
    Thanks – love ur posts!

    1. Yes, Matilda. Females should try to boost testosterone in that case too. Also, progesterone.

  36. Robert Wadhams says:

    Amazing article Ben. I have heard a little about the damage that doing hard events back to back can do, but this is by far the most detailed yet. I have often wondered about this when I hear of runners doing multiple marathons or half marathons to obtain a " half fanatic" or " marathon maniac" title. I'm sure the results would be far worse since many do not know or practice what you do for recovery or nutrition, myself included.

    Thank you for keeping us in the loop.

  37. James Fox says:

    Tom – you may want to look into the service offered by Genova Diagnostics in the UK http://www.gdx.net/uk/
    they offer a full range of blood lipid tests. Unfortunately Uk Lab Testing laws mean you have to work through a practitioner, however if you contact the lab they will let you know which practitioners are registered with them. I’ve used them, and they do provide an excellent service, it’s unfortunate but here in the UK we have to work through a practitioner (this needs to be fixed!).

    Talking 20 is a new service, and I hope they expand the range of tests available, I am going to use them also.

  38. Tom says:

    Thanks for the article Ben, I have been thinking of getting a bit more blood work done, but things work slightly differently over here in the UK, its all free, but you can't just go to your doctor and ask to have these tests done! Even if you are a doctor yourself!
    Quick question about your Ketogenic diet, are you full on ketogenic as apposed to cyclical or targeted? I have been doing 100% keto for a while now, my athletic performance is only better on the keto diet, I have never noticed a drop in being able to to do high intensity training.
    But I am worried about the suggestion that cortisol is raised in ketogenic diets to drive gluconeogenesis, resulting in a depression of testosterone.
    Could this be the reason for your raised cortisol/low testosterone?

    Also, if you are interested in minimalist running, contact me as you might be interested in the research I am doing on barefoot running.

    1. You can actually do Talking20 ANYWHERE in the world. Check this out: http://tinyurl.com/talking20int

      Your body can make glucose out of glycerol backbones during triglyceride breakdown, so if you have enough coconut oil, MCT oil, etc. in a keto diet, it's not an issue!

      And I already do minimalist running, but feel free to email me: [email protected]

      1. James Fox says:

        Ben – I cant thank you enough for the excellent info which you’ve just shared with us. Please keep up the good work, and try not to over do it!

        1. Thanks James…and I am definitely now making concerted attempts not to overdo it.

    2. Ian says:

      Hi Tom,
      Curious how to do this in the UK – who do you got to if not your GP?

  39. Roland Schoeman says:

    Brilliant analysis and interesting to see the impact that stress and

    sport has on the human body. Don’t think we realize just how much we put

    our bodies through.

    I seem to have similar problems. High cortisol levels (24hr cortisol test done)

    Lower end of the spectrum with testosterone. Also higher levels

    of HDl.

    Would be interesting to see day to day blood work for me as well as post

    Olympics or world champs.

    1. Definitely look into some of what I"m doing for "damage control", Roland…this stuff can be mitigated!

  40. kate says:

    Great article Ben! Made me stop and think about what really is important…performance or health. Glad to hear you're saying "no". It's funny how we put so much pressure on ourselves to do more and be more.

  41. Michael H. says:

    Eye-opening stuff, although it also confirms a lot of what I already suspected. I'm wondering about whether you take off-season breaks. Many top athletes and coaches recommend this. At the end of the racing season, I'm more than happy to follow such advice. I find that taking some time off completely and then changing my focus over the rest of the winter (my off-season) to shorter workouts, increased focus on strength training and non-triathlon activities (including casual bike rides on the mountain bike or a commuter bike) helps enormously.

    I shed all of the remaining fatigue from the training and racing season. I get downtime mentally where I'm not worried at all about training. I restore my glycogen levels, and probably my immune system function (and lower my cortisol levels). I usually gain weight. All of this helps me to get a really deep and thorough recovery. Then when it's time to start serious training again in mid to late winter, I'm more motivated and I have more energy than I did in the late fall.

    I think that if I didn't take these off-season breaks, that I might have stopped triathlon, bike and run training after just a year or two. I'm not an elite athlete and never will be. But I do put in a fair amount of time with training in the race season, from mid-winter to summer, then a short break (really a super easy week) in mid-summer, and more training over the summer and fall. (That period is usually just maintenance of race fitness and tweaking my fitness. Not enough time to do a big base building block.)

    I'm also not sure if I'll ever do an Ironman. Besides the extra time commitment and the significant financial expense, I don't think I want to do that to my body. Same thing with a marathon. I ran a slow marathon last year in my marathon debut. I didn't really train for it, other than to increase my run mileage a bit while I focused on an Olympic tri. I'm starting to think that if you can't recover relatively quickly from a race, that it may have a cumulative long-term negative effect on health. Olympic tris, 5Ks, 10Ks and 10-milers are not a problem for an intermediate amateur athlete like me. But I really didn't like how long it took to recover after the marathon last year. I like being active and trying to be the best I can be. But I don't want to dig too deep a hole at any point, and I think marathons might be going past that line for me.

    I think everyone has a limit. It's higher for some than for others, but it's still there Triathlon is a big part of my life now, but I don't want it to destroy the other parts of my life. I'm also hoping to be active well into my 50s and 60s, and avoid serious injury and illness now. No particular point here. Just some thoughts.

    P.S. Scary stuff with the MRSA incident. I had no idea about all of that.

    1. Yes, I do take off-season "breaks" from traditional triathlon training, but my offseason is still kinda hardcore in terms of tennis, weight training, basketball, etc.

  42. Ben, this is a FREAKING AWESOME post. I am currently delving through some of my own WellnessFX results that were interesting, and this gave me some awesome insights to some of my own results ( I did a 30-day plant-based whole foods diet experiment coming off of a bulletproof diet ). Thanks!
    Be well and keep being awesome.

    1. Keep me posted. Very interested in how bloodwork changed with plant-based…

  43. Ryan says:

    Am I overvaluing vitamin D or did I miss that in there? Though it was testosterone related. Super interesting article though. Thanks.

    1. It's in there…but my levels are fine!

  44. anthony says:

    One of the most detailed articles ive ever read, great info, can only imagine what Gerry Duffys bloodwork was like after completing a decairobman, no wonder it took him 14 months to recover

    1. Yes, and more importantly – what does 99% of athletes bloodwork look like not AFTER a hard event, but in their day to day lives?

Leave a Reply

Your email address will not be published. Required fields are marked *