bloodwork-analysis

name	bloodwork-analysis
description	Analyze athlete blood tests (endurance/trail focus) with trends + red flags and produce actionable recommendations for nutrition/recovery and training-plan adjustments (volume/intensity/strength), staying within scope-of-practice.

Bloodwork Analysis (for endurance / trail / mountain running coaching)

When to use this skill

Use this skill when the user provides:

• Blood test results (PDF/images/text) and asks for interpretation.
• Questions about fatigue, recovery, low energy, recurrent illness, poor adaptation, or unexplained performance drop where labs may matter.
• Requests to adjust a training plan based on bloodwork.

Safety + scope (non-negotiable)

• Do not diagnose disease or prescribe medical treatment.
• Do not advise stopping/starting prescription meds.
• If results show urgent red flags or the athlete has concerning symptoms, recommend contacting a clinician (sports-medicine MD / GP / endocrinologist / hematologist as appropriate).
• Use a coaching lens: performance + training tolerance + recovery + risk management.

Inputs required (always ask/confirm)

For each lab set, try to capture:

• Date + lab name/location
• Fasting/non-fasting status; time-of-day (especially for hormones)
• Current training load (last 7–14 days), recent illness, altitude, travel, major stress, menstrual status (if applicable)
• Supplements/meds that affect labs (iron, thyroid meds, creatine, biotin, vitamin D, etc.)
• Units + reference ranges from that lab (do not assume universal ranges)

If results are in PDFs

Preferred workflow:

1. Convert to text/markdown.
   • In this repo you can keep originals in knowledge/blood_tests/.
   • Extract a plain-text copy if needed for analysis.
2. Normalize into a compact “structured summary” (date-stamped) so trend analysis is easy.

Suggested naming for summaries:

• knowledge/blood_tests/YYYY-MM-DD_summary.md

Interpretation workflow (repeatable)

Step 1: Identify the question

Pick one primary coaching question:

• Low energy / fatigue
• Poor recovery / heavy legs
• Recurrent illness
• Weight change / RED-S risk
• Altitude adaptation / hemoglobin
• Heat issues / hydration

Step 2: Triage for red flags

Examples (not exhaustive):

• Very low hemoglobin / hematocrit, severe leukopenia, extremely high CRP, very abnormal electrolytes, marked kidney/liver dysfunction markers. Action: recommend clinician; reduce training intensity and volume until clarified.

Step 3: Endurance athlete “usual suspects”

Prioritize these domains and relate them to training tolerance.

A) Iron status / oxygen carrying capacity

Look at: hemoglobin, hematocrit, RBC indices (MCV/MCH), ferritin, serum iron, transferrin/TIBC, transferrin saturation. Coaching relevance:

• Low ferritin / iron deficiency can reduce training tolerance and economy. Actionable coaching:
• Emphasize dietary iron + timing (heme iron, vitamin C pairing; avoid coffee/tea around iron-rich meals).
• If iron deficiency is suspected, recommend discussing supplementation and follow-up testing with a clinician. Training adjustments (until improving):
• Keep most training Z1–Z2; reduce/avoid adding Z3–Z4 blocks; preserve consistency.

B) Energy availability / endocrine stress (RED-S risk screen)

Look at: thyroid panel (TSH, free T4/T3), sex hormones where available, fasting glucose, HbA1c, lipids, vitamin D. Also integrate symptoms: low libido, menstrual irregularity, persistent fatigue, mood issues, frequent injuries. Actionable coaching:

• Focus on fueling adequacy (carbs around sessions, protein distribution, total energy).
• Consider reducing intensity density and adding rest if under-recovered.
• If RED-S signs are present, recommend clinician and/or sports dietitian.

C) Inflammation / illness

Look at: CRP, WBC differential. Actionable coaching:

• If inflammatory markers are elevated with symptoms: de-load, sleep, and medical check if persistent.
• Avoid hard workouts during acute infection risk.

D) Muscle damage / training stress

Look at: CK (if present), AST/ALT context (can rise with heavy training), resting HR trend, subjective fatigue. Actionable coaching:

• If markers suggest excessive stress: reduce eccentric load (downhill, plyos), shorten long runs, shift to easy aerobic.

E) Hydration / electrolytes

Look at: sodium, potassium, chloride, urea/creatinine, albumin. Actionable coaching:

• If dehydration markers are likely (context-dependent): adjust hydration and sodium strategy; avoid key workouts in heat until stable.

F) Vitamins and micronutrients

Look at: vitamin D (25(OH)D), B12, folate. Actionable coaching:

• Correct obvious dietary gaps; recommend clinician/dietitian for supplementation strategy if deficient.

Producing “actionable recommendations” (required output structure)

When responding to the athlete, structure the answer as:

1. Summary in 3–5 bullets (what matters most for performance/training)
2. Flags
   • Red flags (need clinician)
   • Yellow flags (watch + retest)
3. Likely impact on training (what adaptations are currently limited)
4. Actions (next 2 weeks)
   • Nutrition/recovery actions
   • Training modifications (volume/intensity/strength)
5. Follow-up plan
   • What to retest and when (often 6–12 weeks depending on marker)

Training plan adjustment rules (coach-level)

Use the smallest effective adjustment.

• If red flags: prioritize health → reduce volume 30–50%, remove intensity, keep short easy sessions if symptom-free.
• If iron deficiency suspected: keep training mostly aerobic (Z1–Z2), avoid adding new intensity blocks; focus on consistency + fueling.
• If inflammation/illness suspected: de-load immediately, resume gradually once symptom-free.
• If endocrine/energy availability concerns: reduce intensity density, ensure fueling, consider extra rest day; avoid aggressive weight-loss goals.

If the user explicitly asks for a revised week plan, follow the project output contract:

• Provide the plan in intervals.icu text format.
• Put the “why” inside workout descriptions using - lines.

Repo references

• Blood test originals: knowledge/blood_tests/
• Evidence-based reasoning boundaries: .github/skills/kinesiology-foundations/SKILL.md