why are some values ​​altered?

It is known that the practice of sports induces profound modifications dell’bodyin turn responsible for greater overall functionality.

These are different based on activity and al training load but, above all, based on the type of muscular, metabolic and cardio-respiratory effort.

By improving cardio-circulatory efficiency, the heart pumps more blood and performs fewer beats per minute; in parallel, the pressure drops. Gaseous exchanges improve, the bronchi dilate more easily and respiratory acts decrease in the unit of time. There is almost always good glycemic homeostasis, lipaemia in the safety margins, etc.

At first glance, it would seem that sportsman’s blood tests should be “always perfect”. It’s actually not like that.

Motor exercise, especially intense and/or prolonged, can alter various factors of blood and urine. Due to the increased metabolic activity, in fact, certain parameters “are outside the normal range“; however, they should not be considered pathological markers for this reason.

Understandably however, the first reaction is always “fear”. Follows the basic medical consultation, which unfortunately is not always able to reassure the unfortunate, further addressed to a specialist. At best, the practitioner quickly identifies “the circumstance”, and can establish whether the alteration(s) should be cause for alert or, conversely, whether it is a normal consequence of exercise.

It being understood that, while “cumbersome in appearance”, the diagnostic iter described constitutes the correct path of medical studyin this short article we will try to provide the right information to “reassure” sportsmen unjustifiably ed excessively worry for your own health.

Why can sportsman’s blood tests be altered?

Sportsman’s blood tests can be altered mainly for two reasons:

  1. Exercise-induced hemorheological changes acutely and inimmediate post-exercise. They represent a change immediate of various parameters, a situation for which it is always advisable to carry out the scheduled checks in conditions of absolute rest;
  2. Presence of metabolites e cataboliti That they remain also in long post-exercise. These are physiological alterations that “should” return to normal values ​​after about 1-2 days (but it depends on the training load applied). It goes without saying that, by bringing the sessions closer together, these parameters will be chronically altered – but, we repeat, not pathological for this.

Exercise-induced hemorheological changes

L’contribution optimal Of oxygen to the fabrics is essential for a correct performance endurance athletics (and more).

And’appropriate oxygenation it also depends on the ability to perfusion – therefore from the hemorheological properties* – and from microcirculation.

* hemorheology is the study of the rheological characteristics of blood (degree of viscosity, flow rate, etc.), in normal and pathological conditions.

L’exercise physicist regular it is an element beneficial for the rheological state; however, the impact may vary according to the type, intensity and duration of the stimulus.

It determines modifications is macro-, is micro– rheological, especially in the short exercises and ad alta intensity.

In a recent study dated 2021 (Alterations of Selected Hemorheological and Metabolic Parameters Induced by Physical Activity in Untrained Men and Sportsmen) these changes have been observed in professional athletes (players of soccer e hockey on ice) and individuals don’t train.

The exercise was performed on a conveyor belt in conjunction with the analysis spiroergometrics.

Blood samples were taken before and after exercise, to analyze:

  • concentration of lactate;
  • hematological parameters;
  • viscosity of the blood he was born in plasma;
  • deformability e the aggregation of the Red blood cells (RBC).

Exercise practice has resulted in a increment of the number of leukocytes, red blood cells and platelets, and the viscosity of blood, with maximum entity in the group non trained.

In the post-workout is lightly decreased the deformability of red blood cells, but showed better values ​​in ice hockey than in soccer players.

Red blood cell aggregation increased with exercise, especially in ice hockey players.

Il lactate has increased mainly in the players of soccer and the rate of exchange respiratory it was the most basso in the players of hockey on ice.

Overall, short-term, high-intensity exercise altered macro- and microrheological parameters, especially in the untrained group.

Running blood tests post-workout isn’t the best of ideas.

Non-pathological altered values: what they are, when and why

CPK o creatinfosfochinasi

First of all the haematological markers, capable of terrorizing both inadequately informed sportsmen and general practitioners left in the dark about the patient’s sports habits, we find the CPK (creatinfosfochinasi).

CPK is an enzyme involved in the formation of ATP, i.e. the energy molecule that underlies muscle contraction, but which is found abundantly both in the brain and in the heart.

High levels of CPK in subjects who have the typical symptoms of myocardial infarction or stroke can be considered a very reliable pathological marker. Even the person who complains of very strong muscle pain, by observing a high CPK, can deduce that a frank lesion has occurred in the affected area.

However, subjects with masses major muscleshave levels of CPK circulating superior to thin people. Moreover, if to maintain such a mass, they are inclined to train in hard way e constant in weight training – or in any case of other intense activity – it is natural that the CPK and get up further due to exercise-induced muscle micro-injuries.


Also there creatininemiawhen too high, is responsible for numerous alarms among sportsmen who undergo periodic blood tests.

The creatinine it is the last residue – obtained non-enzymatically – of the metabolism of creatine (muscle reserve of phosphagens). Being a “waste”, it is usually eliminated in the urine thanks to the work of the kidneys.

Therefore, in subjects with kidney problems, plasma creatinine is higher than normal due to impaired excretory function.

That said, above all in sports, the sola creatininemia cannot be considered a valid marker of renal function. This non it means that it is a data negligible or that it shouldn’t be investigated, but simply that its importance depends both on the level of sporting activity and on the extent of this excess in the plasma.

Those who practice physical activity intense e prolonged – especially when dehydrated – often has slightly altered serum creatinine values.

urea nitrogen

L’of nitrogen ureico (BUN) is what’s left over from protein catabolism; it derives above all from the proteins taken with the diet.

It too, like creatinine, should be eliminated thanks to the kidneys; therefore, too high BUN values ​​found in the sedentary person having a “problematic” clinical picture (eg with frankly altered creatininemia), can give strength to the suspicion of a reduced renal function.

However, people who eat “more protein” than would be needed to “even” the protein balance (high protein diet), especially when dehydratedmay show higher than normal blood urea nitrogen – with perfectly healthy kidneys.

Transaminases and other cellular enzymes

The transaminases AST (GOT) e ALT (GPT) are cellular enzymes responsible for the metabolism of amino acids.

They are found in many types of cells, especially in the liver, heart and muscle.

In the sedentary subject, high levels of transaminases are related to a tissue damage; for example a muscle tear, myocardial infarction and liver suffering (severe steatosis, cirrhosis, viral hepatitis, carcinoma, biliary tract obstruction, etc.). An increase in these markers can also be observed after large alcoholic drinks, or the ingestion of specific mycotoxins.

Like other parameters mentioned above, the increase in transaminases must also be contextualized. Finding them high in a sedentary and asymptomatic person is never a good sign, but it does not necessarily indicate a very serious condition – on the contrary, most of the time it is the result of too close revelry.

It would be different if the subject also had hyperbilirubinemia and jaundice; at that point, it would be good to go quickly to the hospital – the interest of the liver is certain, even if the cause is not known. Or if symptoms and clinical signs, even mild ones, of myocardial infarction appear.

As far as non-traumatized sportsmen are concerned, however, the increase in transaminases and other cellular enzymes (CK, LDH, or Gamma-GT) is generally linked to microtraumas of muscle fibers.

Practical advice

In conclusion, the blood tests of the sportsman should be evaluated in a more “elastic” way than the sedentary.

The increase of certain plasma markers, such as CPK, creatinine, BUN, transaminases and other cellular enzymes, in the athlete is often attributable to training practice.

It therefore remains essential to contextualize the out-of-range values, also assessing the general state of health, the presence of useful clinical symptoms or signs, the person’s clinical history and, no less, other more indicative markers.

Doctors should know this. That said, even the medical profession is divided into various branches.

In the event of “not exactly reassuring” news from the healthcare professional, especially being in good health, it is always a good idea to seek further feedback – preferably from a sector specialist.

Wanting to avoid any such problem, those who train could adopt two precautions essential to “normalize” the markers we discussed above, therefore making them more useful in assessing baseline health:

  1. Never submit to a blood sample post-exercise and, if possible, allow at least 2-3 (or even 4) days of absolute rest to pass after training;
  2. Follow a diet sufficiently rich in liquids and not unbalanced on macronutrients; the state of hydration is essential to make haematological investigations indicative, just as a diet balanced on proteins and total calories (and without alcohol) allows for a more precise evaluation of liver health and renal function.

Source: www.my-personaltrainer.it

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