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Overtraining
Syndrome and Immune Suppression
For
beginners…..
If
you are about to begin a rigorous training program, or even if you do moderate
exercise, there is much you can do to prevent immune suppression and
overtraining syndrome from developing. It is common for symptoms such as
fatigue and infections to occur within 2 to 3 weeks of starting training. This simply means that the
body is having difficulty adapting to the new stress caused by training. There
are measures you can take to prevent or minimise these symptoms. The old adage
“prevention is better than cure” is very true in this instance. Ideally,
preventative measures will commence prior to the beginning of training, however
if this is not done start as soon as possible. A full health appraisal can be
carried out to determine any problem areas such as already depleted immunity, a
stressed nervous system, lowered vitality or reduced digestive capacity. Any
additional nutritional requirements can be addressed and appropriate herbal
medicines may be prescribed. A class of herbal medicines known as
‘adaptogen/tonic’ herbs are ideal for athletes. They increase physical and
mental activity and endurance, help the body adapt to stress
(e.g. increased
physical training) and enhance immunity. There are a number of herbal
medicines in this category. I will be able to prescribe those best suited to your needs.
What is overtraining syndrome?
Over-training syndrome is a common
condition in athletes, particularly endurance athletes. However fatigue can occur
in those undertaking moderate exercise. This is more likely to occur if the
diet is not adequate to supply the extra nutritional demands created by
exercise. Overtraining syndrome is defined as a failure of the athlete’s
performance to progress or be maintained, despite an adequate training program
being attempted. Basically, it is the athlete’s failure to adapt to the stress
generated by training.
What causes overtraining syndrome?
The different pathways within the body that
contribute to the development of over-training syndrome are many and very
complex. In this article, for the sake of space and easy understanding, we will
use a broad overview.
One of the major factors associated with
the development of over-training syndrome is inadequate carbohydrate intake.
Athletes who present with over-training syndrome
often have a history of training without
using a quality carbohydrate source to promote recovery after training.
However, eating too much carbohydrate at the expense of protein and fat is a mistake
many athletes make. Endurance athletes have a very high demand for protein and
getting enough quality protein can be one of their greatest challenges.
With increased physical activity there is an increased demand for nutrients. In
many instances, because the training program is so intensive it can be
difficult for the appropriate level of nutrients to be obtained from food
alone. Some of the most important nutrients to prevent problems in athletes
include glutamine, vitamin C, zinc, iron, magnesium, B vitamins, creatine,
carnitine and co-enzyme Q10. Among other things adequate amounts of these
nutrients are essential for maintaining energy production in the body. They
also assist with tissue repair, for example muscle fibres.
What are the symptoms of overtraining syndrome?
Apart from the obvious fatigue and
inability to reach training goals, perhaps the most common symptom is immune
suppression. This results in the athlete experiencing frequent and recurrent
infections. These are often viral (for example repeated colds, flus and herpes)
and can be of a chronic or acute nature. These infections further deplete the
athlete and in many instances render further training impossible until full
rest and recovery are achieved.
Symptoms of nervous system dysfunction
(sympathetic and parasympathetic) include high resting heart rate, increased
heart rate during training, irritability, poor concentration, lack of
motivation, shaking and craving for stimulants such as caffeine products.
Gastrointestinal symptoms may also be present. An increase in gastric transit
time results in loose or watery stools and decreased absorption of essential
nutrients, which further
exacerbates the problem.
Many
studies demonstrate that athletes are very susceptible to infection after
strenuous competition or periods of heavy training.
Unfortunately, immune suppression in
athletes is a very common occurrence causing fatigue, loss of training time,
and a general sense of feeling unwell. Acute (short, aggressive) infections of
the upper or lower respiratory tract are common, however there is usually an
underlying chronic (long-term) suppression of the immune system. This chronic
immune suppression is often caused by a low-grade viral infection and can be
characterised by symptoms that are not obviously related to immune function.
One of the most common underlying viral
infections is Epstein Barr virus, which causes glandula fever, although other viruses may be involved.
The result of this chronic systemic viral infection is erratic, inconsistent
performance, which is not related to rest and recovery. There is often a
sensation of feeling hot without a measurable increase in body temperature.
Under normal circumstances the immune
system keeps chronic viral infections in check. However, in athletes a number
of changes can occur in the immune system that reduces its capacity to provide
protection against infectious organisms. This not only renders the athlete
susceptible to a flare up of the chronic infection, it also makes him or her
much more vulnerable to acute infections such as colds and flus.
What are the changes that occur in the immune system?
It is interesting to note that moderate
exercise actually enhances immune activity but this is not the case with
intense training. There is much research to demonstrate that the immune system
is adversely affected by extreme exercise. The measure of ‘moderate’ and
‘extreme’ is entirely individual. What is extreme exercise for one person may
be only moderate for someone who has an extensive exercise/training program.
Many components of the immune system
exhibit adverse changes after prolonged, intense exertion. These changes can
last between 3 and 72 hours and it is during this time that the athlete is
susceptible to infection. The duration of the transient immune suppression
increases with the amount and intensity of training.
It seems that most immune cells can be
adversely affected by endurance exercise. These include natural killer cells,
macrophages, T-helper cells and immunoglobulins, particularly IgA. Optimal
functioning of these cells is required for immune protection. It is probably
the reduction of IgA concentrations that render endurance athletes prone to
acute respiratory infections. IgA is the first line of defense in the
respiratory tract where it inhibits the binding of viruses to the airways,
prevents them from entering cells and prevents them from replicating. IgA can
be low for up to 18 hours after a 31 km race.
Not only is there a reduction in the
numbers of many immune cells, there is also reduced activity of many of these
cells. For example a decrease in T-helper cells results in a reduced output of
chemicals which activate natural killer cells and other T cells.
As we have already discussed these changes
can last for up to 72 hours. Many ‘serious’ athletes train 5 to 6 days per
week, therefore there is not time for these changes in the immune system to be
normalised before intense training begins again. Without some intervention this
increases the risk of continued immune suppression.
Can overtraining syndrome be treated with natural
medicines?
The answer is ‘YES’. Athletes
suffering from over-training syndrome or those experiencing even a low level of
symptoms can benefit greatly from nutritional and herbal therapies. The needs
of each individual are different, therefore it is best to be professionally
assessed and to have medicines prescribed by a qualified practitioner rather
than self-prescribe. Self-prescription can be a costly option that will usually
not provide the best possible outcomes and in many cases give no improvement at
all.
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