RED FLAGS

Understanding Your Body’s Signals

Your body requires energy not just to power your workouts, but to maintain your baseline physiology—heart function, bone density, immune health, and hormone balance. When training demands exceed your caloric intake, your body enters a state called Low Energy Availability (LEA).

One isolated symptom does not mean you have RED-S. However, a cluster of persistent changes across multiple systems is your body’s way of asking for more fuel.

Energy & Everyday Functioning

Energy deficiency rarely looks like collapsing on the field; it typically starts as a subtle drain.

• Physiological Signs: Persistent daytime fatigue that sleep doesn't fix, difficulty focusing during classes or lectures, and feeling cold when others are comfortable (due to thyroid hormone downregulation).

• Training Impact: Practicing at intensities that used to feel routine now feels overwhelmingly difficult.

• Ask Yourself: "Do I have enough energy to perform in my sport and still function fully as a student and friend?"

Performance & Adaptation

Training stimulates your body to adapt, but adaptation requires energy. Without adequate fuel, added training leads to negative outcomes.

• Declining Output: Loss of power, speed, endurance, or strength despite consistent or increased training.

• Impaired Recovery: Elevated heart rate at rest or during light warm-ups, persistent muscle heavy-ness, and long recovery times between intervals or sessions.

• Decreased Training Response: Feeling like your body has stopped responding to progressive overload.

Bone Health & Injury Rates

Bone is dynamic tissue that constantly breaks down and rebuilds. Estrogen, testosterone, and a good amount of calories are critical to maintaining bone mineral density.

Hormones & System Function

Note: Changes in biological function are medical data points, not small symptoms. If you notice changes here, consult a medical provider.

• Menstrual Function: Irregular periods, light spotting, or amenorrhea (missing 3 or more consecutive periods). Note: If you have only had your period for a few years, it is normal to have some fluctuation in your menstrual cycle due to hormonal changes. However, if the irregularity continues, it is important to contact a medical professional.

• Hormonal Shift: Reduced testosterone levels in male athletes, leading to decreased morning erections, lower libido, and chronic fatigue.

• Gastrointestinal Distress: Chronic bloating, constipation, or slow digestion (gastroparesis), which occurs as the gut slows down to conserve energy.

Mood & Mental Well-Being

The brain consumes roughly 20% of the body's resting energy. When energy is scarce, psychological symptoms often appear before major physical breakdowns occur.

• Irritability & Mood Swings: Uncharacteristic agitation, emotional reactivity, or low mood.

• Brain Fog: Reduced problem-solving capacity, spatial awareness, and concentration during strategy sessions or exams.

• Increased Anxiety: Heightened stress around daily routine disruptions or missed workouts.

Relationship with Food & Exercise

RED-S can occur unintentionally (e.g., high training volume with a busy student schedule) or intentionally (e.g., disordered eating or body composition pressure).

Reflect on your habits:

• Do you feel severe guilt or anxiety when missing a workout or eating unplanned food?

• Do you attempt to "earn" calories through extra training or "cleanse" after eating?

• Do you restrict entire food groups, skip meal windows, or feel uncomfortable eating around teammates?

• Is tracking food, weight, or body shape consuming significant mental space each day?

If you answered yes to several of these, speaking with a sports dietitian or mental health professional can help you rebuild a balanced routine.

Authoritative Sources & Clinical Guidelines

This framework is built upon peer-reviewed sports science and clinical consensus statements:

• International Olympic Committee (IOC): 2023 Consensus Statement on Relative Energy Deficiency in Sport (RED-S) (British Journal of Sports Medicine).

• NCAA Sport Science Institute: Mind, Body, and Sport: Understanding and Supporting Student-Athlete Mental Health and Nutrition.

• American College of Sports Medicine (ACSM): Position Stand: The Female and Male Athlete Triad / Energy Availability in Sport.