Skip to main content

Table 6 Proposed cutoffs for overtraining syndrome

From: Hypothalamic-Pituitary-Adrenal (HPA) Axis Functioning in Overtraining Syndrome: Findings from Endocrine and Metabolic Responses on Overtraining Syndrome (EROS)—EROS-HPA Axis

  Suggested cutoffs Practical application
Salivary cortisol (ng/dL)
30 min after awakening
> 530 ng/dL Highly predictable of exclusion of OTS (93.9%).
370 ng/dL Highly accurate (80%), but unable to help diagnosis OTS
Serum cortisol (μg/dL)
30 min after hypoglycemia in ITT
> 20.5 μg/dL High negative predictive value for OTS (100%)
> 17.0 μg/dL High positive predictive value for OTS, although not specific (28.6%)
19.1 μg/dL High accuracy (84.6%), but not precise for confirmation or exclusion of OTS
Cortisol increase during ITT (μg/dL) > 9.5 μg/dL 100% specific to exclude OTS
Plasma ACTH (pg/mL)
30 min after hypoglycemia in ITT
> 106 pg/mL High negative predictive value (92.9%) and highly accurate (80%)
ACTH increase during ITT (pg/mL) < 35 pg/mL 80% accurate to distinguish OTS from ATL