Some investigators have monitored the urinary cortisol-to-cortisone ratio as a measure of overtraining.

Basis: The ratio of urinary cortisol-to-cortisone ratio can detect an acute phase response that is reflective of overtraining.



(1) urine cortisol concentration in ng per mg creatinine

(2) urine cortisone concentration in ng per mg creatinine


urine cortisol-to-cortisone ratio =

= (urine cortisol) / (urine cortisone)



• An increase in the ratio is associated with overtraining, fatigue and reduced performance.


Practical concerns:

(1) Spot urine collections are more convenient but may not reflect variation in steroid release.

(2) 24-hour urine specimens better reflect steroid release but are notoriously difficult to collect completely and accurately.

(3) The timing of urine collections relative to exercise sessions would influence results.

(4) A comparison of the ratio at baseline (prior to heavy training) versus post-exercise maybetter reflect the athlete's individual response.

(5) An appropriate protocol for monitoring over time could be expensive.

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