Anemia and Running.
December 29th, 2010 | 
Author: In anticipation of heading up to altitude for 4-5 weeks starting Jan 10th, I got some blood work done to check my iron stores and the health of my red blood cells. It had been 3 months since I last checked, and my ferritin (the savings account of long-term iron stores) had dropped from a healthy 88 to an alarming 30 something. That’s still not anemic, but in my experience, once I’m in the 20′s I start feeling like doo doo. And I have been feeling a bit like doo doo lately, so the significant drop should not have come as a surprise.
The thing is, I’ve gotta bring my numbers up pronto because altitude is the bomb. Short bursts of altitude training have historically had a great effect on my training and racing. Oxygen is in shorter supply up there, making aerobic exercise extra challenging. My body attempts to make more red blood cells so there are more vehicles to carry oxygen through my body tissues. And what material does the body require to make hemoglobin-containing red blood cells? Iron. When the demands for iron are larger than what you are getting in your diet, then your body goes to the savings account: ferritin.
The long and short of it is, its hard enough to keep from becoming anemic at altitude when you start with a high ferretin level. I’ve spent the past 10 days trying to boost mine back up, and will continue to do so until Jan 10th. If my blood test doesn’t look much improved by the 9th, I won’t be going to Albuquerque. There would be no point; there’s a good chance I’d be unable to recover properly from my training sessions, and I’d probably end up run down and anemic. There’s a small chance I’d be just fine, but with 2011 being “the year of consistency at all costs,” I won’t take a big risk like that.
I’m very confident that I can get my numbers up. I NEED to. I want to get that training block in so badly! I love Albuquerque and there is so much to be gained! Luckily, iron supplements are perfectly legal, cheap, and readily available. My approach to the mega boost is three-fold:
1. Eat iron rich foods (mostly red meat, clams, and oysters. The vegetarian sources don’t do crap for me.)
2. Take an elemental iron supplement twice a day with O.J. on an empty stomach, 15 minutes before a meal.
3. Avoid iron inhibiting foods (there are many sources for this, but this is a basic one) and beverages with my iron rich foods or supplements. Pair my steak and supplements with foods that encourage iron absorption.
One thing I haven’t done well in the first 10 days is avoid processed wheat. With the holidays, there are way too many good cookies and pastries around, and my discipline has left something to be desired. Had I been flat-out anemic, I would have sacrificed all that crap. Hopefully the last 10 days of all-star eating will boost me up where I need to be.
Crossing my fingers…
Posted in 18 Responses to “Anemia and Running.”
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Also, in school they said that cooking in a cast iron cookware can boost iron. Just a thought.
I also do that! It seems like something that wouldn’t work, but what the hell! Iron cookware is fun…plus its a great weapon if an intruder enters the kitchen.
Your ferritin got up to 88?!? Baller. Mine is 18 (got results today; rbcs a tad low, too). I guess I did have an excuse for all that coffee I drink…(which I will continue to keep drinking).
Very informative post. I think this is an important topic since training and balanced food/nutrition intake need to go hand-in-hand. Point #3 about iron inhibitors is key, and I am guilty of overlooking that one (can’t resist the coffee). Thanks, Lauren!
I don’t think you have to give up coffee (I am an addict as well). I think you just want to make sure you have it at a time when you aren’t trying to boost your iron. The easiest times to boost your iron are first thing in the morning and at dinner. During the middle of the day, you can focus on calcium and other things so you don’t neglect your overall health in an attempt to boost your iron.
I’ve switched my morning routine as follows:
Wake up to orange juice and iron supplement right away on an empty stomach.
Wait 15 minutes to eat breakfast or after my morning run, (avoiding iron inhibiting foods).
Have coffee 2 hours after the iron supplement, around 10am.
Great post! I think this is an incredibly important topic for runners, especially female ones! I, too, struggle with anemia every marathon training cycle and constantly feel like doo doo so I feel your pain!!! I think your 2011 goal is great – consistency! I can’t wait to read about how this, and your all star eating, plays out in your success.
I have found that eating foods high in Vitamin C really have a huge affect on how quickly and efficiently I am able to absorb iron. My fave all star vit- c and iron combo meal is : a big juicy steak, overloaded with red bell peppers, tomatoes, spinach and broccoli, along with some quinoa on the side.
I also eat quinoa flakes for breakfast. You can find them at any natural grocery store and they are already cooked, like oatmeal. All you need to do is add water and micorwave for 2 min and voila- a natural, protein rich breakfast! Not everyone is a fan of the taste ( it’s a little drier/ chalkier than oatmeal) so instead of microwaving it in water, i soak it in 100% apple juice and microwave for 3 min. Much tastier! Just add fruit and it’s a perfect breakfast meal, and the vit c and iron combo again do wonders. Just an idea- these are my day to day go tos.
Keep us posted – i hope you’re able to go to NM and train!
How did you know your tiredness was from anemia and not just training ie what prompted you to go get ferritin levels tested?
I start to suspect anemia when my tiredness feels more like weakness and melancholy. I also look a bit pale.
I had a team mate once who could rub the band of her gold ring across her forehead/cheek and tell if she was anemic or not. If it left a black line, she was anemic!
Melissa, we need an iron boosting cookbook! That sounds like a killer breakfast and lunch combo!
As a natural-born anemic (with a condition called thalassemia) who loves to run, I have really appreciated this post. Thanks so much! .
Lauren,
I too struggle with anemia and I am 53. I have read there is an anemia called “foot strike anemia”……if you can believe it.
My doc says to score the iron tablets, as they will not be absorbed well unless they are. Just use a sharp knife to mark a few lines in the green shell. And, my understanding is you need more than a glass of orange juice.
Good luck! Carla
Carla,
Thanks for the tip on scoring the iron tablets. I switched to all natural mango juice the other day as well…it has 350% of Vitamin C for the day in one glass, so that should help!
Lauren
As someone who struggles with iron deficiency (and I’m a vegetarian) how does processed wheat interfere with the absorption process? Just curious because I’m a high mileage runner who lives at altitude and iron levels are obviously a big concern!
The main problems with wheat are two-fold (three-fold if you are gluten intolerant, but we will ignore that one for now.)
1. Wheat fiber: http://www.ncbi.nlm.nih.gov/pubmed/2820048 Basically, bran has phytates which interfere with iron absorption. Processed wheat in cereals and baked goods usually strip the bran off the wheat and then add it in later so they can say it has fiber in it. Its easier to make wheat products with stripped down soft flour than using sprouted whole grains in their original form from the beginning. Look at the ingredients list for things containing wheat…if wheat bran is listed as separate from wheat flour, in my book its bad news.
2. Quick breads, scones, cookies, baked goods, etc use a good amount of baking powder and self-raising flour, which is high in phosphates, and bad for iron absorption. Runners are prone to order the “healthy” muffins and scones from coffee shops, but oftentimes these are even worse for iron absorption because they use processed flour and then add in bran and fibrous stuff after the fact so it looks all grainy.
So its not wheat itself, but what we do to it that messes our body up. When you are trying to boost your iron, I recommend sprouted grain breads for your sandwiches, plain white flour tortillas rather than bran-added ones, and laying off all baked goods for a while. Sucks but its worth it.
FYI, this is the article I found most helpful scientifically.
Does anyone else get terrible stomach aches from iron supplements? I tried your suggestions of the tablet and OJ on an empty stomach, and almost immediately was hit with dizziness/nausea… any thoughts?
Hi Louise, Yeah that has happened to me before too. Now I take an iron supplement called INNATE hematic response. Its 100% whole food sources and I get it at Bioletics.com I have had no stomach problems with it at all.
[...] What Does Lauren Fleshman Do About Low Iron Levels? The 2010 USATF 5000-meter titleholder found that her ferritin levels were a bit low just as she's about to leave her several weeks of running at altitude training, which she says has "historically had a great effect on my training and racing." She has pretty basic approach to boosting that ferritin – one part of which is to "avoid iron inhibiting foods and beverages." Clock on "More" to find out what those are from Fleshman, a practitioner of "all-star eating." (photo of Lauren Fleshman by Victah Sailer) More [...]
Thanks for this post; very helpful!
As a highschool runner who just started taking iron supplements (twice a day) a few days ago for very low ferretin levels, about how long does it take for it to start kicking in and feeling good again in workouts/races? Thanks!