Sock Doc 6: Caffeine and Dehydration, Train Low Race High, MTHFR’s Role In Your Training, Post Tib Tendonitis, and More

August 11, 2017


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Dr. Steve Gangemi, the Sock Doc, is back on the show. We hear about his latest adventure race and he provides his wisdom on the following:

Sports nutrition – fact or myth? We clarify the following:

  1. Does coffee/caffeine before exercise leads to dehydration?
  2. If you’re fat-adapted can you “race low” (low cal/low carb) during long races? (Or, instead: train low, race high?)
    4. Calorie recommendations and examples for fat-adapted athletes racing long distances.
  3. Does insulin make us fat?
    1. It can/does in certain conditions, but it’s ENERGY BALANCE that ultimately determines fat storage.

Plus answers to your questions:

  • Can having the MTHFR polymorphism impede progress in aerobic training?
  • Supplementing with 5-MTHF (800 mcg) and Methylcobalamin (100 mcg) and muscle soreness.
  • Initial improvements in MAF then a plateau in progress with no improvements after 8 months; what to do? Change training stimulus or could it be MTHFR?
  • Phil Maffetone on when it’s time to add intensity to your MAF training.
  • After knee surgery that included stem cell and PRP injections, what is the recommended downtime before running again?
  • Ryan says: In January I started having pain in the arch and inside ankle of my left foot. I went to see a physical therapist and they said I have posterior tibialis tendonitis.  At the same time, I would also say I was/am recovering from overtraining. In November I started working with Nourish Balance Thrive after figuring out I had low testosterone, hypothyroid, C. Diff, and Candida from lots of training and a low carb/keto diet (I do obstacle course racing). The physical therapy has been helping, I have been having less pain during every day movement and running. I have been doing strengthening exercises moving my foot through various ranges of motion with a resistance band. However, in addition the PT recommended I get orthotics to help support the arches of my feet (I have always been told I have flat feet). I got the orthotics and it has helped but after browsing the Sock Doc’s website it seems he is against orthotics in most cases. My question is what would the Sock Doc recommend to help heal my posterior tibialis tendonitis? Obviously my #1 focus is on addressing my hypothyroid, low testosterone, and gut infections but I also want to heal my posterior tibialis tendonitis as well. Does he think that once I fix my overtraining symptoms will that help my tendonitis? Should I ditch the orthotics or should I wear them until I heal and then start working on running without them? Sorry for the long question, and thanks for all the help!
  • Sock Doc on PF.

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