Relative energy deficiency in sport (RED-S)

Relative energy deficiency (RED-S) is a result of prolonged insufficient energy intake. It’s common in female sports, repeated weight loss and an eating disorder. But also men can experience RED-S.


As said RED-S appear after prolonged insufficient caloric intake and/or excessive energy expenditure. There are many physical and mental problems and systems. Some of them might appear sooner as others, for example, bone changes can take longer appear than the immunological problem.

  • The immunological system; increased sickness and flu
  • Metabolism; the use of glucose for energy slows down and decreases, and overall slower metabolism appear
  • Hormones; estrogen and testosterone levels decrease, catabolic hormones level increase
  • Growth; slower height and weight progress, slower bone growth
  • Mental health; different kinds of psychological problems, depression, change of mood, self-esteem and concentration decrease. Also eating disorders can lead RED-S.
  • Nutrient deficiencies; insufficient carbs, protein, fat, vitamin and mineral intake
  • Menstrual cycle; prolonged of the cycle, absence of menstruation, other symptoms
  • Bone health; increased risk of the stress fracture, bone mineral density decrease, osteoporosis
  • Digestion; stomach cramps, swelling, constipation
  • Cardiovascular system; abnormal fat metabolism, malfunctions


The treatment can vary depending on the symptoms and causes. As it often due to insufficient energy intake, reasons can be linked to an eating disorder. In these cases, it is not right to tell another to just eat more. In each case, one should always consult a doctor and consider what follow-up or treatment needs to be obtained. Recovery time depends on the symptoms, problems, causes, how long these have suffered. Training is usually suspended or changed until the situation improves. The above symptoms do not necessarily automatically mean that you have RED-S, but you should still always check with your doctor if you experience any abnormal symptoms.

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