When to use this
When several low-level signals — cycle changes, fatigue, GI symptoms, mood, small injuries — start stacking up in one athlete.
- A case is muddier than the standard checklist because contraception, PCOS, or puberty is blurring the signals.
- You are deciding whether the pattern justifies a referral conversation with the family.
- Meal consistency has slipped and every other symptom got harder to read.
Evidence sources
These references support the handout’s general education. Individual medical, supplement, laboratory, or injury questions should be handled by the appropriate qualified clinician.
- ISSN Position Stand (2023) Nutritional considerations for female athletes. Journal of the International Society of Sports Nutrition, 20(1):2204066.
- Mountjoy M, Sundgot-Borgen JK, Burke LM, et al. (2023) IOC 2023 consensus statement on REDs. British Journal of Sports Medicine, 57:1073-1098.
- Sim M, Garvican-Lewis LA, Cox GR, et al.(2019) Iron considerations for the athlete: A narrative review.European Journal of Applied Physiology, 119(7):1463-1478.
Where to go next
