Coming soon
The Sports Performance Extension is a separate add-on built on top of the Apex Health and Fitness labs tier. Apex subscribers get the full health and fitness lab interpretation. Sports subscribers get everything in Apex, plus a sport-specific performance layer that maps your results against your sport, your position, and your season phase. The Sports extension will be available after the Apex labs tier launches.
Sports Performance Extension
Requires an active Sports coach subscription. Adds to any Tier 1-4 panel purchase. Sport-specific interpretation applied to all markers across all tiers.
A mid-season soccer midfielder and an off-season powerlifter are not the same patient. Their iron demands differ. Their inflammatory marker thresholds differ. Their cortisol context differs. Their testosterone targets differ by phase.
This extension adds sport-specific blood markers and physical performance testing to any panel purchase. Every result, including results from Tier 1 through 4, is interpreted through your sport, your position, and your current season phase.
Physical performance testing
These tests require in-person sessions at a certified testing facility. ATH will provide referral and context for each protocol.
VO2 Max Protocol
Gold standard cardiorespiratory fitness measurement. Mandsager et al. JAMA Network Open 2018 linked elite VO2 max to a five-fold reduction in all-cause mortality risk compared to the lowest fitness category, a stronger association than smoking, hypertension, or diabetes. Results referenced to sport-specific performance benchmarks, not population norms.
Lactate Threshold
Field or validated laboratory protocol. Your training zones are built from this number. Zone 2 boundary, anaerobic threshold, and maximum lactate steady state all calculated from your individual result. Estimation equations are inaccurate.
Resting Metabolic Rate
Indirect calorimetry only. Estimation equations have error ranges of 200 to 400 calories per day. That margin completely undermines any calorie-based programming. One accurate measurement eliminates years of guessing.
Grip Strength Protocol
Leong et al. Lancet 2015 identified grip strength as a stronger all-cause mortality predictor than blood pressure across every region studied. Standardized measurement with sport-specific age and sex norms. Also used as a proxy for systemic strength and CNS recovery status.
Sport-specific blood markers
Sport Micronutrient Panel
Endurance athletes: iron and ferritin (foot-strike hemolysis depletes iron faster than most endurance athletes replace it). Power athletes: zinc and magnesium (both depleted under high-intensity training). All sports: omega-3 index (anti-inflammatory, structural role in every cell membrane).
IL-6 and TNF-alpha
Extended inflammatory markers for overtraining detection. Acutely elevated post-training is normal and adaptive. Chronically elevated between sessions is the signal to reduce load. These markers distinguish productive inflammation from suppressive inflammation, which is a distinction standard CRP testing cannot make.
P1NP and CTX (Bone Density Markers)
P1NP reflects bone formation. CTX reflects bone breakdown. The ratio shows net bone remodeling direction. Relevant for high fracture risk sports, athletes with extended training years, and female athletes at risk of the female athlete triad. This panel catches bone stress before symptoms or imaging findings.