title: Monitoring changes in performance, physiology, biochemistry, and psychology during overreaching and recovery in triathletes. Monitoring for overreaching in rugby league players Monitoring performance, pituitary–adrenal hormones and mood profiles: how to diagnose non-functional over-reaching in male elite junior soccer players Impaired pituitary hormonal response to exhaustive exercise in overtrained endurance athletes. Can we detect non-functional overreaching in young elite soccer players and middle-long distance runners using field performance tests? Physiological, biochemical and psychological markers of strenuous training-induced fatigue. Catecholamine responses to short-term high-intensity resistance exercise overtraining. Relationships between testosterone, cortisol and performance in professional cyclists. Decreased nocturnal catecholamine excretion: parameter for an overtraining syndrome in athletes? Hormonal responses in athletes: the use of a two bout exercise protocol to detect subtle differences in (over)training status Effects of 21 Days of Intensified Training on Markers of Overtraining
abstract: The present investigation compared responses in previously identified physiological , biochemical , and psychological markers of overreaching in triathletes . Sixteen experienced male triathletes ( .VO(2max ) [ mean + /- SD ] = 55.7 + /- 4.9 mL . kg ( -1 ) . min ( -1 ) , age = 31.3 + /- 11.7 yr ) were divided into matched groups according to physical and performance characteristics , and were r and omly assigned to either intensified training ( IT ) or normal training ( NT ) groups . Physiological , biochemical , and psychological measures were taken at baseline , following four weeks of overload training and following a two-week taper . The IT group completed 290 % greater physical training load than the NT group during the overload period . The subjects completed a 3-km run time trial ( 3-km RTT ) each week in order to assess the time course of change in endurance performance . 3-km RTT performance was significantly reduced ( 3.7 + /- 7.5 % ; p < 0.05 ) following four weeks of overload training in the IT group confirming a state of overreaching . During the same period , 3-km RTT performance significantly improved in the NT group ( 3.0 + /- 1.1 % ; p < 0.05 ) . Following the two-week taper , 3-km RTT performance significantly improved in the IT group ( 7.0 + /- 5.6 % ; p < 0.05 ) . Hemoglobin concentration significantly decreased and urea increased in both groups during the overload period ( p < 0.05 ) . During the taper hemoglobin normalized with a greater increase in the IT group compared to the NT group ( p < 0.05 ) . A significant increase in free testosterone to cortisol ratio was also observed in the IT group compared to the NT group during the taper ( p < 0.05 ) . No significant changes were observed for any other biochemical variables during the period of investigation . The RESTQ-76 Sport question naire showed an impaired recovery-stress state with increased training load , which improved following the taper in the IT group ( p < 0.05 ) . These present results suggest that none of the physiological and biochemical variables measured in this study were effective for the early identification of overreaching in experienced triathletes . However , the RESTQ-76 Sport question naire may provide a practical tool for recognizing overreaching in its early stages . These findings have implication s for monitoring training status in athletes in a practical training setting The aim of this study was to identify indicators of non-functional overreaching ( NFOR ) in team sport athletes undertaking intensive training loads . Eighteen semi-professional rugby league players were r and omly assigned into two pair matched groups . One group completed 6 weeks of normal training ( NT ) whilst the other group was deliberately overreached through intensified training ( IT ) . Both groups then completed the same 7-day stepwise training load reduction taper . Multistage fitness test ( MSFT ) performance , $ $ \ifmmode\exp and after\dot\else\exp and after\.\fi{V}{\text{O}}_{{2\max } } $ $ , peak aerobic running velocity ( Vmax ) , maximal heart rate , vertical jump , 10-s cycle sprint performance and body mass were measured pre- and post-training period and following the taper . Hormonal , haematological and immunological parameters were also measured pre-training and following weeks 2 , 4 and 6 of training and post-taper . MANOVA for repeated measures with contrast analysis indicated that MSFT performance and $ $ \ifmmode\exp and after\dot\else\exp and after\.\fi{V}{\text{O}}_{{2\max } } $ $ were significantly reduced in the IT group over time and condition , indicating that a state of overreaching was attained . However , the only biochemical measure that was significantly different between the IT and NT group was the glutamine to glutamate ( Gln/Glu ) ratio even though testosterone , testosterone to cortisol ( T/C ) ratio , plasma glutamate , and CK activity were significantly changed after training in both groups . Positive endurance and power performance changes were observed post-taper in the IT group confirming NFOR . These changes were associated with increases in the T/C ratio and the Gln/Glu ratio and decreases in plasma glutamate and CK activity . These results indicate that although there was no single reliable biochemical marker of NFOR in these athletes , the Gln/Glu ratio and MSFT test may be useful measures for monitoring responses to IT in team sport athletes Objective To verify if in male elite junior soccer players a minimum 1-month performance decrease is accompanied by a mood profile and hormone levels typical of non-functional over-reaching ( NFOR ) . Design A prospect i ve case-control study using a monthly performance monitor with a st and ardised field test to detect the performance changes . Players with a performance decrease lasting at least 1 month were compared with control players without a performance decrease on mood scores and pre-exercise and postexercise levels of stress hormones . Setting Sporting field and sports medical laboratory . Participants Ninety-four young elite soccer players were monitored during the 2006–2008 seasons . Twenty-one players were invited to the laboratory , seven of whom showed a significant performance decrease . Main outcome measures Performance change over time , scores on the profile of mood states and premaximal and postmaximal exercise serum levels of adrenocorticotropic hormone ( ACTH ) , growth hormone ( GH ) and cortisol . Results Players with a performance decrease showed psychological and hormonal changes typical of the non-functional state of over-reaching . Scores were higher on depression and anger , whereas the resting GH levels and ACTH levels after maximal exercise were reduced . ACTH and GH were capable of classifying all but one player correctly as either NFOR or control . Conclusions Performance-related criteria in field tests are capable of identifying players with worsened mood and adaptations of the endocrine system that fit the definition of NFOR . Performance , mood and hormone levels may therefore be considered as valid instruments to diagnose NFOR in young elite soccer players The aim of the present prospect i ve longitudinal study was to investigate the hormonal response in overtrained athletes at rest and during exercise consisting of a short-term exhaustive endurance test on a cycle ergometer at an intensity 10 % above the individual anaerobic threshold . Over a period of 19+/-1 months , 17 male endurance athletes ( cyclists and triathletes ; age 23.4+/-1.6 yr ; VO2max . 61.2+/-1.8 mL x min(-1 ) x kg(-1 ) ; means+/-SEM ) were examined five times on two separate days under st and ardized conditions . Short-term overtraining states ( OT , N=15 ) were primarily induced by an increase of frequency of high-intensive bouts of exercise or competitions without increase of the total amount of training . OT was compared with normal training states intraindividually ( NS , N=62 ) . During OT , the time to exhaustion of the exercise test was significantly decreased by 27 % on average . At rest and during exercise , the concentrations in plasma and the nocturnal excretion in urine of free epinephrine and norepinephrine were not significantly changed during OT . At physical rest , the concentrations of ( free ) testosterone , cortisol , luteinizing hormone , follicle-stimulating hormone , adrenocorticotropic hormone , growth hormone , and insulin during OT were comparable with those during NS . A significantly ( P < 0.025 ) lower maximal exercise-induced increase of the adrenocorticotropic hormone and growth hormone , as well as a trend for a decrease of cortisol ( P=0.060 ) and insulin ( P=0.036 ) , was measured . The response of free catecholamines as well as the ergometric performance of an all-out 30-s test was unchanged . Serum urea , uric acid , ferritin , and activity of creatine kinase showed no differences between conditions . In conclusion , the results confirm the hypothesis of a hypothalamo-pituitary dysregulation during OT expressed by an impaired response of pituitary hormones to exhaustive short-endurance exercise Objective To study whether field performance tests can make a valid distinction between non-functionally overreaching ( NFO ) athletes and control athletes . Design Monthly field performance tests were used to determine a performance decrement ( PD ) throughout a season . Athletes with a minimum of 1 month PD were compared with control athletes without a PD on mood characteristics and resting levels of stress hormones . Setting Sporting field and sports medical laboratory . Participants 129 young elite athletes , 77 soccer players and 52 middle-long distance runners were followed prospect ively during the 2006–2007 season . Fifteen of them were invited to the laboratory . Eight athletes showed a performance decrease lasting longer than 1 month , and seven athletes without a performance decrease acted as their controls . Main outcome measures Performance changes over time were measured using field tests .  Profile of Mood States and resting levels of adrenocorticotrophic hormone ( ACTH ) and cortisol in blood were measured in the laboratory . Results PD athletes showed several symptoms typical of the non-functional state of overreaching ( OR ) . The PD group scored higher on depression and anger than controls . They also showed a specific pattern of correlations between negative mood subscales ( tension , fatigue and depression ) , which was absent in controls . ACTH levels at rest were similar , but lower cortisol levels in PD athletes pointed at a blunted cortisol response . Cortisol levels were decoupled from ACTH levels only in PD athletes . Conclusions Implementing performance-related criteria in field tests can help coaches and sports physicians to distinguish NFO athletes from athletes with balanced workload and recovery The purpose of the study was to investigate whether severe fatigue , possibly leading to overreaching , could be diagnosed at an early stage by a combination of parameters . Seven well-trained male subjects ( age [ mean + /- SD ] : 25.3 + /- 4.7 yr ; body mass : 76 + /- 6.6 kg ; VO2max : 61.1 + /- 7 ml.kg(-1).min(-1 ) ) increased their training load by doubling their training volume and increasing the intensity by 15 % over a period of two weeks . Before and after this intensified training period subjects underwent a series of tests including a maximal incremental cycle ergometer test ( Wmax ) with continuous ventilatory measurements and blood lactate values , time trial , basal blood parameter tests ( red and white blood profile ) , hormones [ growth hormone ( GH ) , insulin-like growth factor 1(IGF-1 ) , adreno-corticotropic hormone ( ACTH ) , cortisol ] , neuro-endocrine stress test [ short insulin tolerance test ( SITT ) , combined anterior pituitary test ( CAPT ) and exercise ] , a shortened Profile of Mood State ( POMS ) , the estimated rate of perceived exertion ( RPE ) and a cognitive reaction time test . The intensified training period result ed in a significant increase of the training load ( p < 0.01 ) , training monotony ( p < 0.01 ) and training strain ( p < 0.01 ) . The RPE during training increased significantly ( p < 0.01 ) during the intensified training period . Total mood score obtained from the POMS tended to increase ( p=0.06 ) , reflecting an increase in worse mood state . A novel finding was that reaction times increased significantly , indicating that overreaching might adversely affect speed of information processing by the brain , especially for the most difficult conditions . After the intensified training period , neither changes in exercise-induced plasma hormone values , nor SITT values were observed . During the CAPT only cortisol showed a significant decrease after the intensified training period . Hemoglobin showed a significant decrease after the intensified training period whereas hematocrit , red blood cell count ( RBC ) and MCV tended to decrease . The intensified training had no effect on physical performance ( Wmax or time trial ) , maximal blood lactate , maximal heart rate and white blood cell profile . The most sensitive parameters for detecting overreaching are reaction time performance ( indicative for cognitive brain functioning ) , RPE and to a lesser extend the shortened POMS . This strongly suggests , that central fatigue precedes peripheral fatigue . All other systems , including the neuro-endocrine , are more robust and react most likely at a later stage in exhaustive training periods Seventeen weight-trained males were divided into an  overtraining group [ OT ; n = 11 ; age = 22.0 + /- 0.9 ( SE ) yr ] that weight trained their legs daily for 2 wk with 100 % 1 repetition maximum relative intensity on a squat machine and a control group ( n = 6 ; age = 23.7 + /- 2.4 yr )  that exercised 1 day/wk with low relative intensity ( 50 % 1 repetition maximum ) . Test batteries including strength assessment s and resting and exercise-induced concentrations of epinephrine and norepinephrine were conducted at the beginning , middle , and end ( tests 1 - 3 , respectively ) of the study . Strength capabilities decreased by test 3 for the OT group ( P < 0.05 ) . Resting catecholamine concentrations did not change for either group during the study , whereas exercise-induced concentrations of both epinephrine ( test 1 = 3,407.9 + /- 666.6 pmol/l , test 2 = 7,563.7 + /- 1,210.6 pmol/l , test 3 = 6,931.6 + /- 919.3 pmol/l ) and norepinephrine ( test 1 = 42.9 + /- 7.4 nmol/l , test 2 = 70.0 + /- 8.8 nmol/l , test 3 = 85.2 + /- 14.5 nmol/l ) significantly increased by tests 2 and 3 for only the OT group . Correlation coefficients suggested decreased responsitivity of skeletal muscle to sympathetic nervous system activity . It appears that altered exercise-induced sympathetic nervous system activity accompanies high relative intensity resistance exercise overtraining and may be among the initial responses to the onset of the previously theoretical sympathetic overtraining syndrome In the literature the use of plasma levels of cortisol and the testosterone and testosterone : cortisol ratio for training management is encouraged . Decreased levels of testosterone and increased levels of cortisol are suggested to be indicative for a disturbance in the anabolic-catabolic balance , which may express itself in decreased performance . The purpose of the study was to examine if the acute hormonal response to a bout of exercise and the resting levels of testosterone , luteinizing hormone ( LH ) and cortisol are correlated to performance in cyclists . In addition , the effect of training on this correlation was studied . Ten professional cyclists participated and measurements took place before and after a defined period of training . Maximum workload ( Pmax ) , determined on a cycle-ergometer with a slowly increasing protocol , increased by 30 watt ( p < 0.001 ) . Workload at a lactate level of 4 mmol/l ( P4 ) increased by 18 watt ( p < 0.05 ) . Post training , resting testosterone levels decreased from 28.8 + /- 74 nmol/l to 24.6 + /- 90 nmol/l ( p < 0.05 ) . Resting cortisol levels increased from 272 + /- 110 nmol/l pre training to 379 + /- 242 nmol/l post training ( p < 0.05 ) . These results indicate an increased catabolic state . The acute hormonal response and the resting levels of LH were not changed post training . The resting levels of testosterone and cortisol and the acute response to exercise showed no correlation with performance pre and post training . In spite of an increased catabolic state post training there was an increase in performance . These results suggest that in endurance trained cyclists , decreased testosterone levels , increased cortisol levels and a decreased testosterone : cortisol ratio does not automatically lead to a decrease in performance or a state of overtraining The effectiveness of  high performance training  should be examined at short intervals in order to recognize overtraining promptly . Field or laboratory tests can usually not be performed with such frequency . Easy-to-measure biological , training-relevant parameters are being sought to use in their place . Since the importance of the sympathetic nervous system for adaptation of stress and the relationship between physical training and the activity of the sympathetic nervous system are well accepted , and since an impairment of the sympathetic nervous system is assumed in an overtraining syndrome , we examined the relevance of nocturnal " basal " urinary excretion of free catecholamines with respect to its practical application : 1 . during a pilot study ( training of road and track cyclists before the 1988 Olympic Games in Seoul ) , 2 . through a 4-week prospect i ve , experimental study in 1989 and 1990 ( middle- and long-distance runners ) , 3 . during the competitive season and winter break of a soccer team between August 1990 and April 1991 . The following hypothesis was made : An overtraining or exhaustion syndrome in athletes may usually be accompanied by at least a 50 % decrease in basal dopamine , noradrenaline and adrenaline excretion . When training is effective or the athletes are not exhausted , the decrease of the excretion rate -- with the exception of dopamine -- is more likely to be lower ( noradrenaline , adrenaline ) . Generalization of these results requires further expansion of the experimental basis In overtrained athletes , several signs and symptoms have been associated with the imbalance between training and recovery . However , reliable diagnostic markers for distinguishing between well-trained , overreached ( OR ) and overtrained ( OT ) athletes are lacking . A hallmark feature of overtraining syndrome ( OTS ) is the inability to sustain intense exercise and recover for the next training or competition session . We therefore devised a test protocol utilizing two bouts of maximal work . With this test protocol we tried to establish a difference in hormonal responses between the training status of T and OR athletes . Seven well-trained cyclists participated in this study and were tested before and after a training camp . We also present the data of one OT motocross athlete who was clinical ly diagnosed as overtrained . All athletes performed two maximal exercise tests separated by 4 h. Blood was analyzed for cortisol , adrenocorticotrophic hormone ( ACTH ) , growth hormone and prolactin ( PRL ) . Performance decreased by 6 % between the first and the second exercise test in the OR group and by 11 % in the OT subject . Moreover , during the second exercise test there were more marked differences between the T and OR athletes ; in particular , the OT subject did not show an increase in some of the hormonal responses . PRL increased only by 14 % in the OT subject ’s second test and there was a 7 % decrease in ACTH . The two exercise approach enables us to detect subtle performance decrements that will not be identified by one exercise trigger . The hormonal responses to the second exercise test were different between the T and OR athletes ( the increase in the T group was higher than in the OR that was higher than in the OT ) . The results of the case presentation of an overtrained athlete provide evidence of an altered and dysfunctional hypothalamic – pituitary axis response to two bouts of maximal exercise . These findings can be used to develop markers for diagnosis of OTS and to begin to address the pathologic mechanism operative in the syndrome , as well as providing an outcome measure to evaluate possible therapeutic regimes Slivka , DR , Hailes , WS , Cuddy , JS , and Ruby , BC . Effects of 21 days of intensified training on markers of overtraining . J Strength Cond Res 24(10 ) : 2604 - 2612 , 2010-The purpose of this study was to impose a period of quantifiable intensified training to determine if commonly used diagnostic markers of overtraining parallel changes in physical performance and thus overtraining status . Eight trained male cyclists ( 24 ± 1 years , 71 ± 3 kg , & OV0312;O2peak = 4.5 ± 0.1·L·min−1 ) performed 21 days ( 3,211 km ) of  intensified training in the field where volume and intensity were increased over normal training . Salivary IgA , testosterone , and cortisol , 1-hour time trial performance , heart rate response , and profile of mood states ( POMS ) were collected and analyzed throughout the 21-day training period . The POMS category vigor declined from day 1 to day 4 and remained lower throughout ( p < 0.05 ) . There were no other statistical changes in overtraining parameters . However , individuals who demonstrated 2 or more symptoms of overtraining at any point throughout the 21 days were considered symptomatic and had a lower ( p < 0.05 ) & OV0312;O2peak ( 4.2 ± 0.1·vs . 4.7 ± 0.1 L·min−1 ) and lower ( p < 0.05 ) average workload during the initial 1-hour time trial ( 253 ± 5 vs. 288 ± 14 W ) . Interestingly , the 1-hour time trial power in these individuals with symptoms of overtraining did not decline ( p > 0.05 ) . These data demonstrate that markers of overtraining do not parallel a decrease in performance and should be interpreted with caution
target: Basal levels of hormones were mostly normal in athletes with OTS/FOR/NFOR compared with healthy athletes .
  Distinctly , stimulation tests , mainly performed in maximal exercise conditions , showed blunted GH and ACTH responses in OTS/FOR/NFOR athletes , whereas cortisol and plasma catecholamines showed conflicting findings and the other hormones responded normally .
  Conclusion Basal hormone levels are not good predictor but blunted ACTH and GH responses to stimulation tests may be good predictors of OTS/FOR/NFOR
background: Background Overtraining syndrome ( OTS ) , functional ( FOR ) and non-functional overreaching ( NFOR ) are conditions diagnosed in athletes with decreased performance and fatigue , triggered by metabolic , immune , hormonal and other dysfunctions and result ed from an imbalance between training stress and proper recovery .
  Despite previous descriptions , there is a lack of a review that discloses all hormonal findings in OTS/FOR/NFOR .
  The aim of this systematic review is to evaluate whether and which roles hormones play in OTS/FOR/NFOR .