RED-S Dietitian: Specialist Support for Relative Energy Deficiency in Sport
RED-S happens when you're not eating enough to cover both your training and everything your body needs to stay healthy. It is common in athletes and active individuals, and can have significant impacts on your health and performance. As a specialist RED-S dietitian, I help athletes rebuild their fuelling safely and practically, working alongside your doctor, physio and/or coach where needed. Appointment are offered online across the UK, or in person in Cornwall.
What is RED-S (or REDS)?
Relative Energy Deficiency in Sport (RED-S) can happen when you are consuming less energy than your body needs for training and day-to-day functioning. This is often called low energy availability. When it goes on for a while, your body starts to save energy by turning down important systems, including hormones, bone health, immunity and metabolism.
In 2023, the International Olympic Committee updated its consensus statement and the name to "REDs". RED-S replaced the older term "female athlete triad" because it affects athletes of every gender. It can happen with or without a disordered eating or an eating disorder. Sometimes it's simply that appetite, a busy schedule or an increase in training hasn't kept up with what your body needs.
Signs and Symptoms of RED-S
Health Signs
Irregular or missing periods, or periods that haven't started
Low libido
Bone stress injuries or stress fractures
Getting ill often
Gut problems
Feeling cold
Poor sleep
Low mood, irritability or anxiety
If you have ANY of these symptoms, please ensure that you see your doctor or GP for full investigations and a medical check.
Performance Signs
Fatigue or tiredness
Slower recovery between sessions
Strength, power or endurance decreasing
Poor concentration and coordination
Training harder but not progressing
Lack of motivation to exercise
RED-S is treatable with the right multi-disciplinary support.
How I support with RED-S
Assess
A full look at your training load, eating patterns, symptoms, menstrual health (if applicable), injury history and relationship with food.
Fuelling plan
Build a practical plan built around your needs to reduce energy and carbohydrate availability, treat deficiencies, and support healthy food relationships.
Team up
With your consent, I liaise with your doctor, physio, coach or psychologist. I may also recommend that you see other healthcare professionals as part of your recovery.
Review
Regular follow-ups as your energy, training and health change. We will also complete tailored nutrition education to help you increase in confidence in fuelling.
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Yes. Men can experience low energy availability too. It may show up as low libido, fatigue, frequent illness or bone injuries.
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Everyone is different. It depends on how long you've been under-fuelling and how your body responds, so I won't give you a timescale. I'll support you at each stage.
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No. RED-S is a state of being in a chronic low energy availability. It can happen due to an eating disorder, or due to other reasons such as not realising how much you need to fuel your training. If food worries are part of the picture, I'm also a specialist eating disorder dietitian.
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With your consent, yes. Coaches can be a big help in recovery.
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No, you don't need one to book. Depending on your symptoms, I may suggest asking your GP for blood tests (such as iron studies and hormones) or a bone density (DEXA) scan.
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Yes. Teenagers need energy for growth as well as training, so they can slip into under-fuelling quickly, and periods may be delayed or stop altogether. I work with young athletes aged 11+ with parents or carers involved, and with consent I can liaise with schools and coaches.