April 10, 2023

57: Alex Coates, PhD – RED-S, LEA, and Overtraining Syndrome – Are You At Risk?

In this Episode

RED-S, LEA, The Female Athlete Triad, Overtraining, Overreaching, Underfueling…These words and acronyms are pervasive in endurance sports circles but, quite frankly, still cause much confusion and debate. Often, they are mistakenly used interchangeably when the definitions and symptoms do differ significantly.

Today’s guest, Dr. Alex Coates, demystifies each of these concepts and explains them in a way that all active people can understand in order to remain healthy and active throughout their lives.

Dr. Coates is a postdoctoral fellow at McMaster University where she studies systems-level integrative exercise physiology. As a former elite triathlete at the national level, Alex trained and raced on multiple world championship teams and saw first-hand the repercussions of what would eventually become her areas of primary focus – overtraining, underfueling, and insufficient recovery from training.

In fact, she and her sister, Kyla, actually were one of the first to document the existence and definition of RED-S, or Relative Energy Deficiency Syndrome, which presents in both men and women.

In this episode, she and Sara discuss:

  • The differences in the terms Female Athlete Triad, RED-S, and Low Energy Availability
  • Why the Female Athlete Triad needed an update to include RED-S
  • The multiple hormonal symptoms of RED-S and the personal impact it had on Alex’s sister, Kyla
  • The nuances of LEA and RED-S
  • The differences between overtraining and overreaching and the ability to recover (or not)
  • The impact of underfueling on recovery on all types of performance
  • An outline of The FUELED course modules, including the body’s various energy systems
  • Female Athlete Development from Puberty to Adulthood


Dr. Coate’s work hopefully connects the dots foranyathlete suffering from extreme fatigue, thermal regulation issues, performance plateaus, and other hormonal imbalances that may be brought on by extreme training.

Alex is also the lead Exercise Physiologist on the Feisty FUELED course that is launching in April. To learn more visitfueledcourse.com

Fueled: A comprehensive nutrition course for active women by Feisty Media | Coming April 2023:


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