Medical safety

Cardiac screening, RED-S, hyponatremia, rhabdomyolysis and overtraining syndrome.

The section where Leo's job is to recognise a pattern and then step back. It holds formal guidelines rather than exploratory research: ESC sports cardiology, the AHA and ACC statement on competing with cardiovascular abnormalities, the IOC consensus on Relative Energy Deficiency in Sport with its clinical assessment tool, the international consensus on exercise-associated hyponatremia, and the joint ECSS and ACSM statement on overtraining syndrome.

These documents share a structure: named warning signs, and a clear threshold past which the answer is a clinician, not a training adjustment. Leo uses them exactly that way. If what you describe matches a documented red flag, he names it, cites the guideline, and tells you to see a doctor. He does not diagnose, and he will not coach around a symptom that belongs in a consulting room. This section is also why his overtraining response is graduated rather than binary.

Papers in this domain

18 peer-reviewed references. Titles link to the publisher via DOI.

  1. Clinical Considerations for Competitive Sports Participation for Athletes With Cardiovascular Abnormalities — AHA/ACC 2025

    Kim, Baggish, Levine et al. · 2025 · DOI 10.1016/j.jacc.2024.12.025

  2. Clinical Practice Guideline for Management of Exertional Rhabdomyolysis — CHAMP/USU 2025

    O'Connor, Raleigh, Oh · 2025

  3. How do glucagon‐like Peptide‐1 receptor agonists affect measures of muscle mass in individuals with, and without, type 2 diabetes: A systematic review and meta‐analysis

    Anyiam et al. · 2025 · DOI 10.1111/obr.13916

  4. Trajectory of the body weight after drug discontinuation in the treatment of anti-obesity medications

    Wu et al. · 2025 · DOI 10.1186/s12916-025-04200-0

  5. Fundamental Body Composition Principles Provide Context for Fat-Free and Skeletal Muscle Loss With GLP-1 RA Treatments

    Tinsley et al. · 2024 · DOI 10.1210/jendso/bvae164

  6. 2023 IOC Consensus Statement on REDs

    Mountjoy et al. · 2023 · DOI 10.1136/bjsports-2023-106994

  7. IOC REDs CAT2 — Clinical Assessment Tool V.2

    Ackerman, Stellingwerff et al. · 2023 · DOI 10.1136/bjsports-2023-106914

  8. Mapping the Complexities of REDs: Physiological Model

    Burke, Ackerman, Heikura et al. · 2023 · DOI 10.1136/bjsports-2023-107335

  9. Primary, Secondary and Tertiary Prevention of REDs

    Melin et al. · 2023 · DOI 10.1136/bjsports-2023-107297

  10. Semaglutide for the treatment of overweight and obesity: A review

    Bergmann et al. · 2022 · DOI 10.1111/dom.14863

  11. 2020 ESC Guidelines on Sports Cardiology

    Pelliccia, Sharma et al. · 2021 · DOI 10.1093/eurheartj/ehaa605

  12. An Evidence-Based Review of the Pathophysiology, Treatment, and Prevention of Exercise-Associated Muscle Cramps

    Miller, Schwellnus et al. · 2021 · DOI 10.4085/1062-6050-0696.20

  13. Effects of Low Energy Availability on Bone Health in Endurance Athletes and High-Impact Exercise as A Potential Countermeasure: A Narrative Review

    Hutson et al. · 2020 · DOI 10.1007/s40279-020-01396-4

  14. Low Energy Availability in Athletes 2020: An Updated Narrative Review of Prevalence, Risk, Within-Day Energy Balance, Knowledge, and Impact on Sports Performance

    Logue et al. · 2020 · DOI 10.3390/nu12030835

  15. Exercise-Associated Hyponatremia: 2017 Update

    Hew-Butler, Loi, Pani, Rosner · 2017 · DOI 10.3389/fmed.2017.00021

  16. Exertional Rhabdomyolysis: A Systematic Review

    Rawson, Clarkson, Tarnopolsky · 2017 · DOI 10.1249/MSS.0000000000001174

  17. Third International EAH Consensus, Carlsbad 2015

    Hew-Butler, Rosner et al. · 2015 · DOI 10.1097/JSM.0000000000000221

  18. Prevention, Diagnosis and Treatment of OTS — ECSS/ACSM Joint Consensus

    Meeusen, Duclos, Foster et al. · 2013 · DOI 10.1080/17461391.2012.730061

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