{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:14:12Z","timestamp":1783617252211,"version":"3.55.0"},"reference-count":185,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Background: Biomarkers are increasingly used in sport science and sports medicine to monitor training load, recovery, metabolic stress, nutritional status, and potential clinical risk in athletes. However, their interpretation is often limited by overreliance on isolated values, population reference ranges, and simplified thresholds. This narrative review aims to provide a contextual and metabolically informed framework for interpreting routine and emerging biomarkers in athletes. Methods: A critical narrative synthesis was conducted across key physiological domains relevant to athlete monitoring, including exercise intensity, metabolic flexibility, muscle damage, protein catabolism, hydration, hematological and iron status, micronutrient and bone\u2013muscle health, inflammation, endocrine stress, sport-specific interpretation, and emerging metabolomics. The review integrated routine laboratory markers with pathway-level metabolomic interpretation and practical decision-making principles. Results: Routine markers such as lactate, creatine kinase, urea\/blood urea nitrogen (BUN), creatinine, electrolytes, ferritin, C-reactive protein, cortisol, testosterone, and vitamin D are useful only when interpreted in relation to individual baseline, sampling conditions, recent workload, nutrition, hydration, sleep, illness, sex-specific physiology, and performance. Metabolomics expands interpretation by identifying pathway-level signatures involving glycolysis, \u03b2-oxidation, amino acid turnover, purine degradation, ketone bodies, acylcarnitines, bile acids, oxylipins, kynurenine metabolites, and exercise-induced signaling molecules such as lactate, \u03b2-aminoisobutyric acid (BAIBA), and N-lactoyl-phenylalanine (Lac-Phe). However, omics-derived markers require careful standardization and validation before routine applied use. Conclusions: Biomarkers should refine, not replace, clinical reasoning and athlete monitoring. A BASE framework (Baseline, Analytical standardization, Sport-specific context, and Evidence of functional change) may support more precise and proportionate interpretation of both routine blood tests and emerging metabolomic tools in athletes.<\/jats:p>","DOI":"10.3390\/metabo16070483","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T16:16:44Z","timestamp":1783613804000},"page":"483","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Routine Blood Tests to Metabolomics: A Contextual Framework for Interpreting Biomarkers of Training Load, Recovery, and Metabolic Stress in Athletes"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7422-1546","authenticated-orcid":false,"given":"Mario","family":"Mu\u00f1oz-L\u00f3pez","sequence":"first","affiliation":[{"name":"Department of Sport Sciences, Faculty of Sport and Health Sciences, Fit Generation Research Institute, AD500 Andorra la Vella, Andorra"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Quesada-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Sport and Health Sciences, Fit Generation Research Institute, AD500 Andorra la Vella, Andorra"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3947-0822","authenticated-orcid":false,"given":"Edgar Sim\u00f3n","family":"Sancho-Haro","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Sport and Health Sciences, Fit Generation Research Institute, AD500 Andorra la Vella, Andorra"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2199-4767","authenticated-orcid":false,"given":"Xabier","family":"Ram\u00edrez de la piscina-Vi\u00fadez","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences, Faculty of Sport and Health Sciences, Fit Generation Research Institute, AD500 Andorra la Vella, Andorra"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eneko","family":"Baz-Valle","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences, Faculty of Sport and Health Sciences, Fit Generation Research Institute, AD500 Andorra la Vella, Andorra"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7412-7624","authenticated-orcid":false,"given":"Jos\u00e9 Francisco","family":"L\u00f3pez-Gil","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad Esp\u00edritu Santo, Samborond\u00f3n 092301, Ecuador"},{"name":"Faculty of Health Sciences, Universidad Aut\u00f3noma de Chile, Temuco 4780000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Francisco","family":"Tornero-Aguilera","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences, Faculty of Sport and Health Sciences, Fit Generation Research Institute, AD500 Andorra la Vella, Andorra"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Biomarkers Definitions Working Group (2001). 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