mental health

Cold water therapy

Cold water therapy is increasingly popular in Australia, particularly among athletes and wellness enthusiasts. A survey indicates that many Australians are adopting cold water immersion practices, with many using it for muscle recovery, mental health benefits, and overall well-being. According to Pursue Performance, approximately 82.6% of users engage in cold plunges 5-7 times per week, highlighting its regular use in personal health routines.

In my hometown of Torquay, cold water therapy boomed during COVID lockdowns. Groups such as “Torquay ocean waders” became conduits for community connection through ocean dipping and then coffee sipping outside the local Salty Dog café. This sense of community, based on an ethos of adventure, social connection, and a positive attitude, has grown to 1800 members in just three years, offering a supportive network for all.

The number of local female participants in this group intrigued me. I initially wondered if the group’s growing popularity was more about connection than the benefits of cold-water therapy. However, over time, the scientific evidence supporting and validating the health benefits of cold-water therapy has grown, providing reassurance and confidence in its effectiveness.

The menopausal transition adds another layer of complexity to health and fitness. Hormonal changes can affect metabolism, energy levels, and body composition. Despite sound nutrition and plenty of exercise, women in this life stage often complain of central weight gain.

Over 75% of Australian perimenopause or menopausal women will experience vasomotor symptoms (hot flushes and night sweats). Many women also experience sleep disturbances, mood changes and fatigue, as mentioned in our blog.

Cold water therapy is linked to improvements in exercise recovery, hormonal balance, and the management of symptoms such as hot flushes associated with menopause. This knowledge empowers women to take control of their health and well-being.

Cold water therapy can offer many benefits for women.

  1. Regular exposure to cold water can help reduce inflammation.
  2. In a study conducted at the University College of London, women reported cold water therapy reduced levels of anxiety, mood swings and depression.
  3. Cold water therapy can improve your immunity. Following exposure to cold water, the body releases catecholamines such as epinephrine and norepinephrine, which stimulate the immune system.
  4. Cold water immersion post-exercise for active women can aid muscle recovery, reduce soreness, and enhance overall physical resilience.
  5. Cold water therapy has also been suggested to reduce the frequency and severity of hot flushes.
  6. Regular exposure to cold water therapy may reduce cortisol levels associated with stress.
  7. Exposure to cold water is a habit spreading for the selective reduction of adipose tissue, improvement in insulin sensitivity, and is popular with anti-ageing proponents.
  8. Cardiovascular risk factors associated with heart disease are also reported to be reduced after just three weeks of cold-water therapy.

The evidence is clear- regular cold-water therapy holds many benefits for women, especially those experiencing symptoms associated with menopause.

Visit the Athlete Sanctuary for more personalised advice and resources. We support athletes in achieving their best selves through tailored strategies and a compassionate community.



AusPlay. (2022). Participation data for running and jogging. Retrieved from Australian Sports Commission.

Australian Institute of Sport. (2023). Nutritional considerations for female athletes. 

Bleakley, C. M., & Davison, G. W. (2010). What is the biochemical and physiological rationale for using cold-water immersion in sports recovery? A systematic review. British Journal of Sports Medicine, 44(3), 179-187.

Doets, J. J., Topper, M., & Nugter, A. M. (2021). A systematic review and meta-analysis of the effect of whole body cryotherapy on mental health problems. Complementary therapies in medicine63, 102783.

Esperland D, de Weerd L, Mercer JB. (2022).Health effects of voluntary exposure to cold water – a continuing subject of debate. Int J Circumpolar Health.

Janssen, H., Ada, L., Karayanidis, F., & McElduff, P. (2016). Ankle dorsiflexion strength after cold-water immersion in older adults: Implications for early stroke rehabilitation. Journal of Stroke and Cerebrovascular Diseases, 25(4), 867-872.

Miller, E. G., Maren, K., & Swanson, S. (2020). Cold-water immersion therapy and its effect on the alleviation of menopause symptoms: A randomized controlled trial. Journal of Women’s Health, 29(7), 951-958.

Smith, D. L., McHugh, M. P., & Allen, D. W. (2019). Cold-water immersion and recovery from exercise: Effects on menopause-related symptoms. Menopause, 26(8), 870-876.


Low zinc symptoms

The high demands of sports make athletes more vulnerable to illness, with 65% of athletes experiencing regular colds and infections. Zinc is a key nutrient required for immunity and keeping an eye out for low zinc symptoms, may just make the difference between being sick or great performances.

It can be so frustrating to put in many months of hard training only to be sidelined during a taper or on race day by heaving lungs, debilitating fatigue, and a pounding headache. Sports performance is materialised through consistency, akin to writing a book, one page at a time. Forced breaks from training due to illness detract from progress and drains confidence. Not all athletes rest when unwell and opt to “push through” the illness only to experience prolonged symptoms and more disruption to competition. 

Building a robust immunity is all part of a holistic approach to coaching and training. So how do you minimise your risk of getting sick? 

There are many nutrients that contribute to a healthy immune system as discussed previously.

Athletes may be more susceptible to being deficient in zinc because exercise, particularly strenuous and endurance exercise, increases zinc requirements, encourages zinc loss through sweating, and changes zinc transportation and metabolism.  

In our opinion, zinc plays the most critical role in supporting athletes and immunity.

Zinc’s role in hormone control and immunity

Zinc regulates several crucial processes in both your innate and adaptive immune system. Being deficient in zinc can lead to athletes becoming more susceptible to respiratory illness, particularly in the colder months. 

Apart from zinc’s well-established role in immunity, this mineral, contributes to protein structure, regulates gene expression, metabolism and is the second most abundant trace element in the body after iron.  Zinc deficiency can impact an athlete through hormone dysregulation (testosterone, thyroid, and growth hormones to name a few) and may affect erectile function and fertility.

Zinc is essential to maintaining optimum performance due to its function in metabolism and healthy cell division – essential in repairing damaged tissues after you exercise.

Studies show being deficient in zinc can lead to a reduction in the number of fast-twitch muscle fibres and muscle mass and performance decline.  For Masters Athletes this is of particular relevance as aging is also associated with sarcopenia, the age-related loss of muscle mass, muscle strength, and physical performance.

Zinc also helps maintain blood sugar control and assists with muscle contraction during exercise, glucose metabolism, and glycogen storage.

Zinc also plays an essential role in antioxidant production by increasing antioxidant activity and inhibiting free radical production that may damage tissues, impact liver function, and prevent muscle exhaustion.

Low zinc symptoms

Apart from recurrent colds and other infections, there are many low zinc symptoms.

*Anxiety and depression

*Hormone imbalances

*Poor concentration

*Stomach pain and gas

*Slow healing

*White spots on nails

*Skin issues and acne

*Loss of appetite

*Loss or change of smell

*Changes in taste

Zinc rich foods

The most concentrated sources of zinc are contained in animal products, particularly meat, seafood and dairy.   Vegan and plant-based athletes may be more susceptible to zinc deficiency due to reduced dietary intake, lowered gastric acid (which is zinc-dependent) and higher phytate consumption.  Phytates found in plant-based zinc-rich foods such as legumes can inhibit zinc absorption. 

Soaking nuts and seeds and legumes prior to cooking is a great way to minimise this issue and allow for greater micronutrient absorption.

Iron absorption 

The gastrointestinal tract plays an important role in maintaining total body zinc homeostasis by regulating zinc absorption and excretion. In order to boost your absorption, the addition of a probiotic may be beneficial.

In certain situations, zinc supplementation may be recommended. The amount ingested, supplement form, and the timing of zinc matters. Speak to a naturopath or nutritionist with an interest in sport before self-prescribing. You’ll definitely want to avoid zinc toxicity. High zinc levels can have a detrimental impact on your performance through anaemia, copper and iron deficiency and unpleasant gastrointestinal side effects.

Zinc testing

Serum blood testing is used by some conventional practitioners to determine zinc levels in the body. Keep in mind 60% of zinc is stored in muscle and 30% in bone therefore serum may not be the best measure of zinc homeostasis.  A mineral test can be another alternative method of assessing zinc levels and is available through our clinic as explained here.

If you need help building a robust immune system, book an appointment with our naturopath.


About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://


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    2019 Jan;32(1):231-239. PMID: 30772815.
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Vitamin D deficiency

Vitamin D deficiency has consequences well beyond bone health.

Vitamin D is gold.

Vitamin D is so important to the body, immune cells, brain, colon, breast, and other cells have the ability to also activate it locally when required. Although labelled a vitamin, calcitriol (bio-active vitamin D) acts more like a hormone within the body. It is involved in many essential functions well beyond bone health.  Vitamin D is critical for inflammatory modulation, hormonal and immune functions as well as cardiovascular, mental health and pancreatic function. The active form of vitamin D interacts with receptors in the intestine, bone, brain, heart, immune cells and skeletal muscle.  Vitamin D functions as a modulator of up to 1000 genes involved in cellular growth and protein synthesis.

Vitamin D plays an important role in an athlete’s health, training and performance.

Studies show it may even be necessary for optimal muscle function and performance as muscle performance is impaired by suboptimal vitamin D status. Deficiency induces atrophy of fast twitch muscle fibers, impairs calcium uptake and prolongs time to peak contractile tension and relaxation. Studies also show Vitamin D deficiency may delay rehabilitation from injury.

In sporty pregnant women, low vitamin D levels are linked to pre-eclampsia, gestational diabetes and adverse pregnancy outcomes. Vitamin D also plays a part in regulating insulin, blood sugar balance and thyroid hormones. Research shows that a deficiency of vitamin D is associated with a high risk of thyroid antibodies, which are found in individuals with autoimmune thyroid disorders.

Vitamin D is most commonly known in the athletic community for its influence on bone health and prevention of bone injury. Vitamin D influences bone health by upregulating expression of genes that enhance intestinal calcium absorption, and reabsorption by the kidneys along with increasing bone-building cell activity. Studies show calcium absorption significantly increases when vitamin D levels are sufficient. Calcium absorption is reduced to 10-15% with low vitamin D levels and stress fracture risk significantly increases.

Typically, 80% of our vitamin D is obtained from the sun and 20% from food sources.

Signs of Vitamin D deficiency

  • fatigue and tiredness
  • lower back pain
  • recurrent colds and infections and poor immunity
  • stress fractures
  • heaviness in the legs
  • recurrent injuries
  • muscle pain, weakness, poor muscle contraction and relaxation
  • mental health issues, low mood, seasonal sadness and depression
  • hormonal imbalances and PMS
  • anaemia and low iron
  • pale floating stool
  • photosensitivity

According to Sunsmart Australia, one-third of Australians are low in Vitamin D.

10 Reasons your vitamin D is low

Vitamin D can be made by our body when skin is exposed to sunlight through a complex activation process, however, what many people fail to realise is that this process doesn’t always occur efficiently or reach levels required for optimal health. Vitamin D production may vary depending on the time of day of sun exposure, season, cloud cover, smog, latitude, skin pigmentation, age, and sunscreen use.

We often see patients with low levels of vitamin D despite being out in the sun daily. There are several reasons why vitamin D levels drop despite sunlight exposure.

1. As vitamin D is fat-soluble and stored in fat cells, individuals with low body fat, may be disposed to vitamin D deficiency as their storage tank is smaller.

2. Activation and production of vitamin D are inhibited by magnesium deficiency, inflammation, and excessive use of sunscreen.

3. Individuals with any form of malabsorption issues, liver or kidney issues, coeliac’s disease, Crohn’s, vegans, and thyroid issues can be prone to deficiencies.

4. Anyone with a history of anaemia should also be aware of the bidirectional influence between iron and vitamin D. The activation of vitamin D in the kidneys requires iron-containing compounds ferredoxin reductase and ferredoxin. Iron deficiency may therefore contribute to the inactivation of vitamin D. Vitamin D deficiency may also be associated with higher hepcidin (a pro-inflammatory mediator) in the liver.  Hepcidin will elevate ferritin stores and down-regulate intestinal absorption of iron from food and impair storage iron release. Hundreds of athletes have used our handy anaemia tool to help determine the likely risk of having low iron or anaemia.

5. Diets containing limited seafood, eggs or dairy such as vegan diets may also reduce vitamin D intake.

6. Insufficient direct UVB exposure (due to smog, cloud cover or latitude), early- or late-day training, indoor training, geographic location further away from the equator and sunscreen use (SPF of 15 lowers vitamin D synthesis capacity by 98%).

7. Disruption to the microbiota and gut inflammation may also affect the availability of vitamin D.

8. In addition some individuals may find it difficult to increase their vitamin D levels if they have low antioxidant status.

9. Medications such as anticonvulsants, corticosteroids, cimetidine, theophylline, statins or the weight loss drug orlistat.


As a general guide, Osteoporosis Australia recommends most people should have levels of at least 50 nmol/L at the end of winter, which means people may have higher levels during summer (60-70 nmol/L). However, in order to maintain optimal health, athletes should aim for serum levels over 90 nmol/L ideally between 100 and 130 nmol/L.


Daily sunlight exposure on your skin especially on large areas such as the back, chest, legs and arms (25-60 minutes in winter) without suntan cream, is a great way to keep levels topped up. Athletes living in southern states of Australia and New Zealand need 30 minutes of direct skin exposure (springtime) on large areas of skin such as back, arms, chest or legs closer to midday. Athletes living closer to the equator may require 15 minutes before 10 am. During this time avoid putting sunscreen on, then for the rest of the day, cover up. Lunchtime exercise with as much skin exposure as possible (within decency) is a great way to give yourself a vitamin D fix, especially in winter months.

Get tested biannually- before winter and again in spring.

Consume vitamin D-rich foods on a daily basis such as oily fish like cod, salmon, sardines or tuna, egg yolks, sun-dried mushrooms, and fortified milk, butter and fortified cereals. Some individuals may benefit from cod liver oil which also contains vitamin A and essential fatty acids.

When levels are low, take a quality supplement in the correct dosage range and a probiotic. Certain probiotics such as Lactobacillus rhamnosus LGG and Lactobacillus plantarum enhance levels synergistically.

Obtain adequate magnesium-rich foods such as spinach, pumpkin seeds, almonds, black beans, oyster mushrooms, avocado, figs, yogurt or kefir and banana. Chocolate also contains magnesium.


About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://

accurate pathology tests

In this article, we discuss how to obtain accurate pathology tests. Whilst this article is not meant to serve as a diagnostic tool, it may be helpful to better understand what basic pathology tests are useful and how to prepare yourself so you get the most accurate results.

Pathology test results should always be considered in conjunction with symptoms, a thorough physical examination, and discussed during an appointment so that the context and relevance of your results can be determined. One abnormality in pathology tests does not tell much of your health picture, however, patterns of pathology tests can provide a holistic picture of your overall health, your absorption, and digestion of key nutrients and provide warning signs that require further investigation.


Your GP or naturopath can arrange pathology tests for you. Exactly which pathology tests you require, will need to be determined by your healthcare practitioner. As a good starting point, I suggest the following tests for my patients:

*Full blood count and hematology- provides a general picture of your immune system, red blood cells and overall health

*Liver function tests (LFTs)- provide some clues as to how your liver is working and if your liver is under stress.

*Electrolytes– including potassium, sodium, and other key electrolytes required for sports performance and optimal health

*Fasting blood glucose- is a general marker that indicates how well your body is modulating your blood sugar. Issues with blood sugar stabilisation may cause symptoms such as sugar cravings, frequent urination, fatigue, and energy drops after meals.

*C- reactive protein (CRP) is an inflammatory marker that is useful when interpreted in conjunction with iron studies. Iron storage may be impacted by states of high inflammation.

*Iron studies- provides information on your iron storage (ferritin), the protein carriers for iron (transferrin), and how effectively your body is saturating these carriers and transporting iron around your body (transferrin saturation).

*Thyroid hormones- TSH, T3 and T4 provide information on how your thyroid is functioning and can be an early warning sign of autoimmunity and nutrient deficiencies such as iodine, selenium, tyrosine and zinc

*Vitamin B12 ( active and inactive) is also suggested for plant-based patients or athletes who infrequently consume red meat.

*If you are prone to mental health issues (especially seasonal sadness/ low mood), autoimmunity, frequent colds, bone health issues, or hormonal imbalances vitamin D, copper and serum zinc may also be useful markers.

Tests may be repeated every few months to ensure a patient is responding to treatment and improving nutrient absorption through targeted nutrition approaches.

How to get the most accurate pathology tests

To get the most out of your pathology tests, it is recommended your prepare appropriately.


  •  fast for 12-16 hours (have dinner and then postpone breakfast until after your blood draw).


  • strenuous exercise for a minimum of 24 hours. Ideally, at least 48 hours if possible.  This includes running, cycling, or strength training. Most patients find it easiest to do a blood test the morning after a rest day.
  • obtaining the blood draw when feeling unwell such as with a cold or flu when checking iron studies as infection may influence your test results
  • alcohol or supplements for 24-48 hours prior to your blood tests

We use a number of pathology collection centres across Australia including Clinical Laboratories, Dorevitch, and Nutripath to obtain accurate pathology results. We also refer to functional testing such as mineral testing completed through Interclinical Laboratories.


About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://