How is RED-D managed?

If you think you might have RED-D then the best way to manage this is to talk to someone you trust, who can direct you to a specialist sports medicine physician. Your sports physician will discuss your symptoms, order necessary tests, and do a comprehensive clinical review which may lead to the diagnosis of REDs. As a syndrome, it involves an complex interplay of symptoms, making diagnosis a process of exclusion. A joint monitored plan from relevant, specialist members of a multidisciplinary team is best practice, the plan can then be implemented and reviewed together.

Some key factors that will be considered are:

• Screening tests

  which may include; Questionnaires (LEAF/LEAM/DEAQ), discussion around hormonal health/symptoms including menstrual history and libido, discussion around injury (parotuccary bony injuries) and illness’, and sleep quality/quantity, and mood, looking at growth and development charts and strength & conditioning profiling results over time where possible (to identify if any reduced muscle strength or reduced endurance performance).

• Diagnostic tests

  which may include; gynaecological ultrasound, bloods (especially looking at bone biochemistry, endocrine markers, cardiac tests such as blood pressure (sitting and standing), heart rate and an ECG test, Vitamin D and full blood count markers), DXA to look at bone mineral density.

• Nutritional assessment

  . Where possible it is highly important to get input from a specialist nutritionist to help assess and support dietary intake, supplements, recovery and meal plans where this may be helpful.

• Psychological assessment

  and then support as may be needed to support recovery. Psychological problems can be both the cause and result of REDs so it is very important to address.

• Evaluating

  dance work/training load. Where necessary, modifying these loads in the short term, to support energy balance may be recommended.

• A structured physical training program to include resistance training to promote good bone health

• Check blood Vitamin D levels and supplementation as advised where necessary

• The possibility of hormone therapy, if clinically low, such all transdermal estradiol therapy with cyclic oral progestin in females and testosterone in males, to aid with supporting bone health, muscle mass maintenance and to support strength gains and aid performance.