Introduction: Acute bupropion (BUP; dopamine/noradrenaline reuptake inhibitor)

In overtrained athletes, several signs and symptoms have been associated with the imbalance between training and recovery. However, reliable diagnostic markers for distinguishing between well-trained, overreached (OR) and overtrained (OT) athletes are lacking. A hallmark feature of overtraining syndrome (OTS) is the inability to sustain intense exercise and recover for the next training or competition session. We therefore devised a test protocol utilizing two bouts of maximal work. With this test protocol we tried to establish a difference in hormonal responses between the training status of T and OR athletes. Seven well-trained cyclists participated in this study and were tested before and after a training camp. We also present the data of one OT motocross athlete who was clinically diagnosed as overtrained. All athletes performed two maximal exercise tests separated by 4 h. Blood was analyzed for cortisol, adrenocorticotrophic hormone (ACTH), growth hormone and prolactin (PRL). Performance decreased by 6% between the first and the second exercise test in the OR group and by 11% in the OT subject. Moreover, during the second exercise test there were more marked differences between the T and OR athletes; in particular, the OT subject did not show an increase in some of the hormonal responses. PRL increased only by 14% in the OT subject's second test and there was a 7% decrease in ACTH. The two exercise approach enables us to detect subtle performance decrements that will not be identified by one exercise trigger. The hormonal responses to the second exercise test were different between the T and OR athletes (the increase in the T group was higher than in the OR that was higher than in the OT). The results of the case presentation of an overtrained athlete provide evidence of an altered and dysfunctional hypothalamic-pituitary axis response to two bouts of maximal exercise. These findings can be used to develop markers for diagnosis of OTS and to begin to address the pathologic mechanism operative in the syndrome, as well as providing an outcome measure to evaluate possible therapeutic regimes.

Objective protocol can be used to make an objective, immediately available distinction between non-functional over reaching (NFO) and overtraining syndrome (OTS) was studied. Design with the suspicion of NFO or OTS were included in the study. Recovery of the athletes was monitored by a sports physician to retrospectively distinguish NFO from OTS. Setting Sports medicine laboratory Participants by 10 underperforming athletes. NFO was retrospectively diagnosed in five athletes, and OTS was diagnosed in five athletes. Interventions was used to measure physical performance and stressinduced hormonal reactions. Main outcome measurements rate and blood lactate concentration were measured at the end of both exercise tests. Venous concentrations cortisol, adrenocorticotrophic hormone (ACTH), prolactin and growth hormone were measured both before and after both exercise tests. Results in OTS compared with NFO, while resting concentrations of cortisol, ACTH and prolactin concentrations were higher. However, sensitivity of these measures was low. The ACTH and prolactin reactions to the second exercise bout were much higher in NFO athletes compared with OTS and showed the highest sensitivity for making the distinction. Conclusions NFO might be distinguished from OTS based on ACTH and prolactin reactions to a two-bout exercise protocol. This protocol could be a useful tool for diagnosing NFO and OTS; however, more data should be collected before this test can be used as the gold standard.The goal in training competitive athletes is to provide training loads that are effective in improving performance. At some stages during the training process, athletes may experience an unexplainable decrease in performance. This might happen when prolonged excessive training takes place concurrent with other stressors and insufficient recovery. This unexplainable performance decrements can result in chronic maladaptations that can lead to the overtraining syndrome (OTS). A keyword in the recognition of OTS might be ''prolonged maladaptation'' not only of the athletic performance but also of several biological, neurochemical and hormonal regulation mechanisms. When athletes deliberately use a short-term period (eg, training camp) to increase training load, they can experience short-term performance decrement, without severe psychological or lasting other negative symptoms.1 2 This functional over reaching (FO) will eventually lead to an improvement in performance after recovery. However, when athletes do not sufficiently respect the balance between training and recovery, non-functional over-reaching (NFO) can occur.1 2 At this stage, the first signs and symptoms of prolonged maladaptation such as performance decrements, psychological disturbance (decreased vigour, increased fatigue) and hormonal disturbances are present, and the athlete will need weeks or months to recover. The distinction between NFO and OTS is very difficult and will depend on the clinical outcome and exclusion diagnosis.The recent ''consensus statement'' of the ...

The findings in the literature suggest that T1DACD is more severe in adults than children, indicating that age and diabetes duration contribute to this T1DACD.

Based on this meta-analysis, we can conclude that the addition of brief bouts of high-intensity, sprint-type exercise to aerobic exercise can minimize the risk of sustaining a hypoglycaemic episode. We can also conclude that only regular aerobic training will improve the glycated haemoglobin level of a patient with T1D.