Q: Can’t Boost My Iron! What should I do?
Hi Lauren,
As an athlete I’ve struggled to manage my ferritin and it has begun to get frustrating. There was a while I was getting a blood panel done at least every 6months, mostly to track our athlete specific trends for our team physiologist. Two years ago now my ferritin took a nose dive from 72 down to 30 and has since then continued to slowly dwindle. Currently at a pale 19.
The first dive happened after I moved away from home (where I ate game meat regularly) to living in the Olympic training center, so I could see the dietary link to the decline. However since then I have been living outside a cafeteria setting, taking periodized iron supplements ( recently trying the liquid kind) but my stores just keep sliding.
I’m wondering if you have found any strong link with gluten? My diet is primarily based on vegetables (leafy greens, etc), hearty grains, and lean red meat. With a bunch of endurance athletes in the house we eat pretty well but we do eat a bit of (very gluten-y) bread…. I guess I’m grasping for straws… help?
Corrine
A:
Corrine,
Mmmmmm….oysters….in a can.
A couple iron rich foods you could try to get an extra boost are clams, muscles, and oysters. They are much higher than beef! 20 small clams has 295% DV of iron compared to 35% DV in a 6oz steak! You could either eat them for dinner, or have a tin of smoked clams with crackers for a snack or at lunch. They are magic. The tins are cheap and portable and loaded with iron. Some people think they are disgusting, but I like ’em, kind of. Well I like the results 🙂 When my iron is low I’m desperate, and I’ll eat anything besides liver and onions. That shit is nasty.
What about wheat? There are links between wheat and iron for some people, but from what I understand it’s only an issue when pairing the iron with wheat at a given meal. If you have a turkey sandwich for lunch and then a steak and potatoes for dinner, that shouldn’t matter.
If you have celiac disease, then it’s a different story. Gluten could definitely be the cause of your declining iron in that case, and it would also be causing a decline in lots of other vitamin and mineral stores as well. I’d get a blood test for celiac or gluten intolerance before sacrificing your diet unnecessarily. Bread is just too damn good. But yeah, don’t eat it with your iron if you’re having trouble keeping the iron up.
Too much fiber can interfere with iron absorption too. This is the secret culprit for most athletes who are eating iron but still experiencing low blood levels. A lot of athletes inadvertently make it harder and harder to absorb iron because they are trying so hard to get raw veggies and whole grains in, but fiber gets things moving quickly through the system, and you can have too much of a good thing. Less time in the intestines means less time for vitamins and minerals to absorb. If you have frequent loose stools, this probably applies to you.
The daily recommendation for fiber is 25-35 g per day. Athletes trying to be really healthy often eat double that, especially if they have high fiber cereals or products that fiber is added to to lower the overall “net effective carbs” or things of that nature (low carb tortillas for example). Count up what you are getting per day for a couple days and then make adjustments. You can always cook your veggies a little more to break down the fiber, or eat lower fiber fruits, or a simpler bread.
Worst case scenario, if your iron stays low like that and you can’t bring it up with diet and supplements, you should talk to a doctor. Anemic women are prescribed an iron infusion in situations like these, whether they are athletes or not. Anemia plagues women all the time due to periods and God knows what else. When people have distressed guts that won’t absorb the iron, the only way to get your levels up is to bypass the gut and get the iron into the bloodstream through an IV. But all infusions of any kind are considered a “prohibited method” against WADA/USADA rules unless a doctor feels it is medically necessary and the appropriate TUE documents are filed.
As a shameless plug, Picky Bars are a good source of non-heme (vegetarian) iron naturally, due to the nuts and pumpkin seeds. The iron is part of the ingredients naturally, not enriched after the fact with a crushed up vitamin like most bars. Real food nutrients are more bioavailable (more absorbable). Take a look at the nutrition facts.
ALF readers, if you have any personal experience with this topic that can help Corrine, please include it below! Thanks in advance! Good luck Corrine. Check back in, would ya?
Lauren
Hi Lauren and Corrine,
I’m a high school senior and I just learned over the summer that I had low ferritin levels. My sophomore year I had an injury and was out for the entire season. For the next track season and both XC and track my junior year, I would feel really tired during races and was not performing to the level that my practice showed that I could. Finally, I decided to get my blood tested to see if I had low ferritin, which I should have done much earlier. My ferritin level was 15 which is really low. I went to my sports medicine doctor and he recommended that I take a ferritin supplement twice a day for a month, and then once a day for a month and then get my blood tested after that. I haven’t gotten my blood tested again yet (although I’m about to) but I am feeling so much better in practice and felt great in my first race. My time compared to last year was about a minute faster and the conditions were worse (horrible heat). Granted it was only a 2 mile race but I can tell that it has helped. My workouts in practice have been better and more consistent too.
It did upset my digestive system, however. For the first week or so of taking it, I wouldn’t run anywhere without a bathroom on the route or far away from my house because I would always have to go so badly during my run. It did get better after a while once my body got used to it.
I will let you know what my level is once I get my results back!
Hopefully this helps!
Just a quick update to my first comment–the ferritin supplement has helped me a ton! That combined with my summer training has made such a difference that I am running around a minute faster than I was last year, if not more than a minute!
Hi,
My ferritin levels are low as well. What is the name of ferritin supplement you were taking?
Thanks,
Lisa
Hi Madeline,
What is the name of your ferritin supp ms what dose are you taking each day? I just found out I have a ferritin level of 7. I am so tired and barely can participate in athletic activities. Any help or suggestions would be greatly appreciated!!
Ivy
Cast iron pans and liver! I make a really tasty pâté every other week and eat it with eggs in the morning. And only use cast iron. Has helped my iron levels a bunch!
I’ve struggled with low ferritin levels for 6 years and wrote about it in this post: http://runawayfastjaymee.blogspot.com/2009/08/bitter-irony.html
There are a number of things that interfere with iron absorption including calcium and the tannins in tea. It is also im
Oh my gosh, I think you may have just identified why I’ve been struggling for the last year. I’ve had low iron as long as I can remember (I’m mid-40s now) and for close to a year I’ve struggled with overtraining, overuse injuries, extreme tiredness and sluggishness. Yet I keep getting told my iron levels are ‘Ok’. I’ll be heading off to get a serum ferritin test done asap!
Sorry that comment got away! It’s also important to take iron with a source of vitamin C. Hopefully some of this will help!
Journal of Food Composition and Analysis article concluding that “…live and minced clams should not be considered good sources of bioavailable iron, and the high Al content of whole baby clams raises concerns about recommending these clams as an iron source.”:
http://www.deepdyve.com/lp/elsevier/evaluation-of-clams-as-a-food-source-of-iron-total-iron-heme-iron-XqmXT96KhM
Also, after quite a bit of looking, the best article I’ve seen about iron in runners is on page 8 of this techniques magazine:
http://www.pageturnpro.com/Renaissance-Publishing/41924-Techniques-August-2012/index.html#1
The pageturnpro article was really informative! Thanks for posting that for future readers. Also, that’s interesting about clams. There is conflicting evidence on that subject, but this article makes interesting points worth consideration. Just goes to show that what you read on labels is only part of the story. That being said, my personal experience with clams has netted me very positive results. Red meat is my preference though.
I’ve never had low enough iron to need a ferritin test, but I do donate blood a lot and you need a minimum 12.5g/dL hemoglobin level. I struggle to make the cut, since I don’t eat meat, but I found that a breakfast of oatmeal with walnuts and raisins, plus a big glass of OJ (not calcium fortified — apparently calcium inhibits Fe absorption) will put me well over the mark! The Red Cross folks say the raisins and vitamin C are key. I’ve also heard the tannins in tea can inhibit absorption, so limiting that might help. Good luck!
If you haven’t continued taking supplementary iron – I would suggest you do so (even though you are seeing limited results). Make sure you take the supplement without things that limit absorption (like tea). I used to take mine with breakfast which included tea. I changed my approach and take as soon as I get up, I run or do my workout and eat over an hour later so the iron has time to absorb. I had extremely low ferritin for several years. I’m pre-menopausal (which may be a factor for me) but also had issues as a late teen-young adult. From the time they started tracking to the time I finally reached the lowest of the “in-range” it took 3-4 years. In the middle of this time frame my primary care required me to go get checked out by a gastro to ensure there was no underlying concern, cancer, celiac, etc. There were no relevant findings – and lately I’ve been a bit tired on runs and light-headed so I may be back down. Ultimately – I know it’s an issue – keeping aware. The gastro did say that a negative finding for celiac didn’t mean that someone could have an intolerance. So you never know on the gluten.
I have an interesting story re: ferritin … for anyone whose ferritin keeps dropping and can’t figure it out, might want to check this out.
It was 4 years ago, my college junior year. In the outdoor track season, I just kept getting slower and couldnt’ figure out why – and kept feeling more tired. I was recovering from a bout of pneumonia and working a lot, so I figured it was that, so I didn’t go to the doctor till a couple months later – when at that point I could not even walk up stairs I was so tired.
They tested my ferritin and it was 1. Yes, ONE. And the hemoglobin was 7. For some reason they didn’t do a blood transfusion and just started me on pills – but couldn’t figure out why it was so low. I ate red meat at least 3x a week, leafy greens, etc all the right dietary stuff. I had a rare and really light period, so that wasn’t it. And I wasn’t doing abnormally high mileage at the time – maybe 60 miles a week.
Finally after weeks of specialists they came up with a super interesting (at least to me, since I’m a nurse) diagnosis = foot strike hemoglobinemia. Basically, red blood cells (and therefore, ferritin is effected) are produced in the bones – foot bones included. So doctors discovered this during the civil war from soldiers marching for days on end – endless pounding on their heel bones etc. So apparently my miles and constant walking from the nursing job did the same thing – killed the baby blood cells and ferritin faster than it could be produced.
So because of this they changed the dose and type of iron supplements, and throughout my senior cross country season just got less and less tired, and my season got better and better. So if anyone has mystery iron/ferritin loss, maybe just mention this to the doctor – footstrike (march) hemoglobinemia.
http://en.wikipedia.org/wiki/Mechanical_hemolytic_anemia
Hi,
of course being a woman a source of iron loss could be the monthly issue. That can be controlled with certain birth control pills- some you can take without a break, if you are having issues with that. The best absorption of an iron supplement happens with vitamin-c containing juice right in the morning on an empty stomach, but that may irritate your tummy. At least make sure not to take iron with dairy products like milk (thus, Calcium containing) lowering the iron absorption. Usually the bloodtest for celiac disease is quite specific/ sensitive and especially if the intestinal biopsy comes out clear, it really is nearly excluded you suffer from that. Of course it is important to have a normal diet with gluten when taking the test or having the colonoscopy. It seems that the self-diagnosed ´gluten intolerance´is quite common among runners who oftentimes needlessly restrict their diets to an unhealthy extent.
To supplement this thread, there is an article in the 11/2013 issue of Running Times titled, “Ironing Out The Details.” It starts on page 28.
I know this is an old thread. But I’m curious if any of the advice has helped Connie with her Iron levels.
I had a long history of problems with my iron and so does my sister, mother and grandmother. I was taking suppliements and being careful about what I was pairing with my meals to ensure maximum absorption without good results.
Turns out, I have a genetic problem where certain B vitamins are not easily processed. And so, my cells cannot easily absorb iron. I was taking prescription Iron supplements, but since my cells couldn’t easily absorb the iron it didn’t matter how much iron I injested. My body simply couldn’t use it. Evidently, knowledge about this specific defect is pretty recent. It’s MTHFR Defect – there is a bunch of information online if you put this in your web search.
It’s a very simple test, just a few blood samples. And my insurance covered most of it. I think I paid out something like $50, including the copay.
I don’t know if Connie is having the same problem as I was, and I’m certainly not assuming that everyone has the same problem as I do. But if she is not having successful results increasing her iron levels, then she might want to have this conversation with her doctor. A discussion with her parents and grandparents may be helpful as well.
Good luck.
Hi Emily –
I am curious which MTHFR defect you have — I have the defect and extremely low ferritin. What have you done to increase your ferritin levels? Any supplements, diets, that work? I am trying to find out as much as I can. Per my doctor’s instructions, I started taking liquid B12 along with methyl folate which is supposed to help with the vitamin B12 absorption (although my B12 isn’t really low).
Vitamins B, C, F, zinc, iron, copper and pteroin are essential for hair growth. Drinking plenty of water and eating plenty of raw fruits and vegetables is probably the best way to achieving healthy hair. Check out
Hi – I’ve lost almost all my hair in the last 3 years…skin and nails are a mess… bleeding heavily through perimenopause at age 52.
My ferritin level is 6.7; Iron is 18; and Transferrin Saturation is 4.64. Hemoglobin is 9.7.
I am a vegetarian.
Please tell me how to raise these levels effectively and quickly.
Thank you.
Hi Monica, take iron citrate (25mg x 3 capsules) with ester-C (calcium abscorbate form of vitamin C) daily. Iron citrate and calcium abscorbate will not cause side effects like an upset stomach , constipation, etc. they are available on Amazon website ..
Hi Monica, take iron citrate (25mg x 3 capsules) with ester-C (calcium abscorbate form of vitamin C) daily. Iron citrate and calcium abscorbate will not cause side effects like an upset stomach , constipation, etc. they are available on Amazon website
Hi Lauren! I understand that this is a very old post put it applies well to my situation. I’m a high school runner with low iron. As well, I’ve struggled with amenhorea for 3.5 years. I’m now experiencing pain in my foot that my doctor believes might be a fracture. Of course if it is a fracture, I will not be competing this outdoor season. I’m looking for advice when it comes to competing if my foot is not fractured. Do you think it would be valuable to not run this season to restore my cycle and iron? I will be running next year at a large, competitive university. Any advice you have would be so greatly appreciated. By the way, loving the ROO podcasts!!
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I have the opposite problem. High iron source food comes back up if eaten. And I mean violently.
The only iron pan I have is a skillet. Only eat cornbread that is made in it. That doesn’t make me sick.
If I eat liver in any type recipe it will come back up. Why do you think this happens?
I have a 16 year old son (I know-rare!)/ elite level XC/Track athlete who was diagnosed with anemia last October with ferritin at 11. He’s been taking liquid ferritin with oj or beet juice twice a day and increased meat consumption etc. since diagnosis. He felt and performed much better even after a month, and his performance and training has continued to really improve since. But we just got his levels retested this week and they are still only at a 28 when we were hoping for much higher. The only thing I can think of is that he has oatmeal not long after the am dose but it never has milk (calcium).
Any insight?