Alterations in Redox Homeostasis During Recovery From Unexplained Underperformance Syndrome in an Elite International Rower.

This case study of an international rower examines a diagnosis of Unexplained Under Performance Syndrome (UUPS or Overtraining Syndrome) describing a full recovery and return to elite competition the same year. On diagnosis and 4 and 14 months post-diagnosis, detailed assessments including physiological, nutritional, and biomarkers were made. Clinical examination and laboratory results for haematology, biochemistry, thyroid function, immunology, vitamins and minerals were unremarkable and did not explain the presentation and diagnosis. Redox biomarkers including hydroperoxides, plasma antioxidant capacity, red blood cell glutathione, superoxide dismutase, co-enzyme Q10, vitamin E (α and γ-tocopherol), and carotenoids (lutein, α-carotene, β-carotene) provided evidence of altered redox homeostasis. The recovery strategy began with 12 days of training abstinence and nutritional interventions, followed by 6-weeks of modified training. Four months post-intervention performance had recovered strongly, resulting in the athlete becoming European champion that same year. Further improvements in physiological and performance indices were observed at 14 months post-intervention. Physiologically relevant increases in concentrations of carotenoids were achieved at each post-intervention time point, exceeding the reported critical difference values. We conclude that increasing athlete phytonutrient intake may enhance recovery and tolerance to training and environmental stressors, reducing the risk of unexplained under performance syndrome. Alterations in redox homeostasis should be considered as part of the medical management in unexplained under performance syndrome. This is the first reported case study of an elite athlete with alterations in redox homeostasis in conjunction with a diagnosis of unexplained under performance syndrome.