musings of a gluten free runner » Anemia

Pumpkin Seeds for Strength

admin — Wed, 17 Jun 2009 21:08:34 +0000

Last night I made Pumpkin Seed butter. I needed an iron boost… (this will be a whole other post) and pumpkin seeds are an excellent source of iron! So you may be asking yourself, what do you do with pumpkin seed butter? Well, just about anything that you would normally do with peanut or almond butter. I have a terrible habit of eating nut butters out of jars with spoons. I’ve been doing this since I was little. And I’ve gotten more than a few friends and roommates begrudgingly hooked on the habit over the years.

This pumpkin seed butter is an excellent additive to smoothies and also a great ingredient in raw energy bars like the ones in the Thrive Diet book. I like to make variations on Brendan Brazier’s bar recipes and keep them wrapped in wax paper in the freezer for snacking and quick breakfasts.

So to make the pumpkin seed butter…

Soak the desired amount of seeds for at least an hour. (you don’t HAVE to soak them, but they will blend easier and break down more easily in your digestive system).

Add pumpkin seeds (2-3 cups) to food processor or high powered blender. (I love my 3HP K-Tech)
Add sweetener to taste (suggestions include: local raw honey, raw agave, grade B maple syrup, or stevia)
Add a few pinches of salt (use Celtic sea salt or Himalayan pink salt for added minerals)
You may need to add a little coconut oil or water for added creaminess when blending especially if using stevia.

The chart above is from the World’s Healthiest Foods, they are a great resource for nutrition information on plant-based foods: www.whfoods.com

Finding Partners in Health

Dana — Thu, 11 Jun 2009 14:54:44 +0000

Selling the bakery has really been an impetus for me to address some underlying health issues that I have been let sliding for some time. Yesterday I had an appointment with a naturopathic doctor here in Portland to talk about solutions to my low iron levels, digestive troubles, and fatigue. I also have an appointment with a new endocrinologist next week!

I know it might seem like anyone who is able to run 70 mpw should have plenty of energy, but it’s all relative. I used to have energy coming out of every pore of my body… I never sat still!

Any athlete who is trying to push their body in any capacity, even if it is just recreationally, knows when something is off. As athletes we demand more from our bodies and frankly require a higher level of health. Having a doctor or health care provider that understands this is IMPERATIVE. I always try to get referrals or interview a doctor before I see him/her to make sure that they work with athletes, or in the very least understand the increased demands that training places on the body. This goes for Primary Care Providers, ND’s, Acupuncturists, Masseuses, OB’s, Endocrinologists, Allergists, etc. They have to be willing to treat your symptoms and not treat to a broad desired range that might work for the general public.

For instance, some doctors consider a “normal” serum ferritin (shows how much iron is stored in the body) range to start as low as 18 mcg/L and I’ve even seen ranges starting as low as 3 mcg/L! A common recommendation is for runners to be over 30, however, many top athletes and coaches strive for ferritin levels over 100 mcg/L. It’s one of those things that is very dependent on the athlete. We have a girl on our team who has naturally high iron, and she starts to feel terrible when her ferritin gets down to the 60’s. This is why regular blood tests are a good idea, so you have a health history and can see changes over time. We test our team 2 x per year to establish baseline levels and make sure that everyone is staying on top of things.

The increased demands that endurance sports place on the body just mean that we have to pay extra attention and make it important to find great partners in your health. If you aren’t receiving the treatment that you need, don’t be afraid to show your doctor research and get second or third opinions. Be your own advocate!

Behind the Scenes… “You… The Distance Runner”

Dana — Tue, 14 Oct 2008 05:17:00 +0000

I found this article particularly comprehensive relating to diet, bone health, and iron issues in competitive distance runners…

Distance Running
excerpted from:
http://www.healthline.com/hlbook/nut-distance-running

To go long distances, especially those longer than 10,000m, runners place a premium on relying primarily on aerobic metabolic pathways during the majority of the run. Runners who are capable of doing this rely mainly on fat for the majority of fuel, enabling them to limit the usage of carbohydrate. Carbohydrate storage is finite, but fat storage is, from a practical standpoint, limitless. The higher reliance on fat enables long-distance runners to run very long distances. It also enables them to preserve carbohydrate for moments during the race when they require fast acceleration (e.g., at the end of the race or while passing another runner). According to one study, only 2 to 7 percent of the total energy burned in aerobic activity is derived anaerobically.24 A small amount of carbohydrate is used even when maintaining aerobic activity, so distance runners must develop strategies for delivering carbohydrate during the run. A failure to do so will result in either low blood sugar or low muscle glycogen, both of which impair endurance by leading to premature muscle fatigue.
Keeping this in mind, distance runners must consider the following nutritionally relevant factors for their sport.

Long-distance runners are at risk of amenorrhea, low bone density, and stress fractures. The distances that these athletes run weekly to train may predispose them to stress fractures, despite the potential stimulating impact of running on skeletal mass.25 Although stress fractures occur more frequently in women runners than in men, all runners should ensure that their calcium intake is adequate to reduce the risk of fracture. Female runners are at higher risk of stress fractures because hard endurance training is often associated with cessation of the menstrual cycle. The reduced estrogen associated with amenorrhea is linked to lower bone density. Therefore, runners who experience either primary or secondary amenorrhea should seek appropriate medical advice to determine if rea son able steps can be taken to return to normal menstrual status.26

Female runners should take the following steps to reduce the risk of osteoporosis:
Consume calcium (1,500 milligrams per day) from food or a combination of food and supplements.
Avoid overconsumption of protein because excess protein is associated with higher urinary calcium losses.
Control the production of stress hormones (particularly cortisol) by maintaining hydration and blood sugar during exercise.

Avoid overtraining, which is associated with amenorrhea.

Inadequate energy intake is a red flag that the intake of vitamins and minerals may also be low. A study comparing the nutrient intakes of trained female runners who were amenorrheic, oligomenorrheic, or menstruating normally found clear nutrition differences between these groups, despite being matched on height, weight, training distance, and body fat percentage.27 The runners who were not menstruating had zinc intakes well below the recommended level of intake and lower than those found in the runners who had normal menses. In addition, the runners who had normal menses had higher intakes of fat and a more adequate total energy consumption. This suggests that high-carbohydrate diets, which are preferred for optimal performance, make it more difficult to consume the needed level of energy because carbohydrates have a lower caloric density than high-fat foods. Therefore, athletes should concentrate on consuming more food when carbohydrates constitute the main energy source. A failure to menstruate normally is a strong risk factor in the development of weaker bones and resulting stress fractures. Female runners have good cause to be fully aware of the adequacy of their energy and nutrient intakes because almost no injury is more frustrating or potentially career ending than the development of frequent stress fractures. Endurance runs require enormous amounts of energy (a marathon requires about 2,900 calories); they cannot be adequately trained for or run without an adequate total energy consumption. Food intake strategies, including eating snacks between meals and consuming snacks or sports beverages before, during, and after exercise, are important for ensuring that fuel consumption matches need.
Elite runners depend heavily on both fat and carbohydrate for fuel to accelerate and vary speed over the course of a long-distance race.

Surveys of distance runners confirm that total energy and carbohydrate intakes are below the recommended levels, suggesting that runners must make a concerted effort to consume the recommended amounts before, during, and after exercise.28,29 In a case study assessing the nutrient intake of an ultraendurance runner during a race, it was found that if the pre-event and during-event guidelines for food and beverage are followed, then athletes will have sufficient energy and fluids to successfully complete the event.30
Tapering activity before a competition improves competition performance.31 It does so by increasing glycogen stores, but it also makes the runner calmer, which gives the athlete an improved economy of running motion that enhances endurance. The importance of tapering exercise and of carbohydrate loading before an important event cannot be overemphasized.

Fluids are crucial. Fluid consumption should be on a fixed time schedule (every 10 to 15 minutes) to avoid underhydration and thirst. Perhaps no single factor is more important for ensuring a long-distance runner’s success than maintaining an optimal hydration state. Athletes should drink now, drink again in 10 to 15 minutes, and when they believe they’ve had enough, they should drink
more. Of course, the type of beverage consumed is also important.

A great deal of body heat is generated over the course of an endurance run, and this heat is liberated through sweat evaporation. Studies strongly suggest that a 6 to 7 percent carbohydrate solution with electrolytes is most effective in maintaining exercise endurance.31 It has been firmly concluded that acute heat exposure is detrimental to muscular endurance.32 Therefore, long-distance runners should develop the habit of frequent fluid consumption to maintain body water status, whether they are thirsty or not. A fluid intake of .5 to 1 liter per hour is sufficient to prevent significant dehydration in most athletes in mild environmental conditions, but a greater intake of fluids is needed for athletes running at higher intensities or in more severe environmental conditions in order to avoid heat stress.33

Distance runners typically have relatively low body fat levels. Successful long-distance runners are commonly thin, and this body profile may be advantageous to them in dissipating heat during long runs.34 However, since very low body fat levels are associated with amenorrhea, female athletes should seek a balance between low body fat levels and normal hormone function.

A critical factor in the performance of all endurance athletes is iron status, and evidence exists that endurance runners have reduced hemoglobin, hematocrit, and red blood cell counts when compared with strength and mixed-trained athletes.35 Iron status is sufficiently important that one of the more common illegal ergogenic aids used by endurance runners is erythropoietin (EPO),36 which stimulates the production of red blood cells, thereby enhancing oxygen-carrying capacity.37 Iron is an essential oxygen-carrying component of hemoglobin (red blood cell iron), myoglobin (muscle cell iron), and ferrochromes (oxygen-carrying enzymes essential for making ATP) in the mitochondria. It appears that hemoglobin status is of highest priority, so iron from other cells is cannibalized to support a normal hemoglobin production when iron stores (ferritin) and intake are inadequate. Therefore, a standard blood test measuring hemoglobin may appear normal while other iron-containing cells are depleted. For this reason, it is important that blood tests in endurance athletes always include a measure of ferritin, which should be at the level of a minimum of 20 nanograms per deciliter. Besides having an inadequate dietary intake, which is most common in runners who do not eat red meat or who are vegetarian, there are several other common causes of low iron status in runners:38-40

Excess iron loss in sweat
Excess loss of blood through the GI tract
Excess loss of blood in the urine (hematuria)
Excess menstrual blood loss in female runners
Poor absorption of iron
Intravascular hemolysis

To Detox…

Dana — Sat, 22 Sep 2007 02:05:00 +0000

Ahh, I am getting a bit of a headache. Sometimes I wonder if I am hypoglycemic or something.

Today is the first day of my “fall cleaning” detox. Yesterday on my run home from downtown, I decided that I needed to take some action and be proactive about changing how lousy I’ve been feeling. I don’t want to put the entire blame on the iron pills, because it might have been a little before that… but they are an easy scapegoat.

A few weeks ago I purchased a copy of the Raw Food Detox Diet and have been contemplating making some changes to my diet. I eat far too much imitation cheese, tortilla chips, cashews, dried fruit and energy bars. And not enough fresh produce. The ironic thing to me is that I am the OPPOSITE of constipated all the time… and I’m drawn to these foods that are dense, both literally and calorically. And yet, I have NEVER remotely had problems with elimination.

In fact, this last spring I went in for a colonic and the therapist told me that I was probably not a good candidate for colon hydrotherapy because of my “constitution”… saying that I have a tendency toward coldness and watery stools, etc. (sorry to be graphic) I do simply just HATE the idea of old putrid waste lining the walls of my intestines and allowing toxins to absorb back into my tissue. yuck!

Last weekend I purchased a new juicer, the one that the author of the book recommends for its ability to handle a large quantity of greens. I’ve been scared away from so many of the “green” drinks and powders since going gluten-free. You see, wheat grass or barley grass shouldn’t contain gluten, BUT it could. The “could” comes from the fact that once it is processed we have no way of knowing whether the grass sprouted first. If it did- then the juice could contain gluten. ugggh, it is another one of those huge gray areas for me.

So I decided, that I should juice my own green goodness from veggies- hence the new juicer.
I know what you’re thinking: “what about the fiber?” Well, I have three answers for this:
1) I could never handle tough greens like Kale, period.
2) Myself, and most people, would be hard pressed to eat the vast quantity of veggies it takes to make a couple glasses of juice
3) Since our bodies have a difficult time processing much of this hard plant matter, we are probably not absorbing all the vitamins and minerals that are locked inside.

So, I’m going to start juicing again regularly. I’m even going to try to stomach beet juice, it is such a good blood builder.

More on my progress later. Off to the lab to get some blood drawn.

New Iron Pills…. hmmm

Dana — Thu, 20 Sep 2007 04:46:00 +0000

OK- started another iron pill this weekend…. and I think this one will be relegated to the “Ian” pile once again. Although he has his own digestive issues, he seems to have a much easier time with the iron varieties than I do and he’s not gluten intolerant…. (or so he insists).

This one was from Wild Oats- their brand- and it said gluten free on the label. It is seriously the craziest capsule I’ve seen. The outside is clear and it is filled with different brightly colored beads. The nice thing is that it said slow-release, and the capsule contains vitamin C, folic acid and b12 to aid absorption… so I was thinking it would cut down on the amount of pills I take at night. (Although I do enjoy my chewable vitamin Cs!)

I might give these the benefit of the doubt… since it is almost that time of the month and my stomach might be ultra sensitive. I even had to stop doing the mile repeats in the workout yesterday because my tummy was making so much noise… PAINFUL!
So, I’ll give them to till the end of the week…maybe I won’t take any Friday night since I’ve got a tempo Saturday morning. Then it is back to the Gentle Iron for me.

uggh.

You Are My Sunshine…. Vit D

Dana — Sat, 08 Sep 2007 03:49:00 +0000

Ahhh…. the sun just came out! It’s streaming through the window behind me warming my legs. Hopefully there’s no UV coating on this glass… I need my daily dose.

This morning felt so cold, I couldn’t believe it. And all day has been cloudy so far. Just another reminder to swallow those Vitamin D pills when I get home tonight from my long day up on the hill.

Up until about a year ago, I never paid Vitamin D much attention. All I really knew was the basics:

it works along with calcium and magnesium for bone health

your body makes it from sunshine

it’s added to pasteurized milk in this country

it’s fat soluble like Vitamin A- which means you can overdose because your body stores it instead of excreting it through sweat/urine.

Pretty much all common knowledge. It wasn’t until I went down to see the Endo in Houston that I learned that I had a severe vitamin D deficiency. (I found this very ironic, since until I moved to the Pacific Northwest, I felt like I spent my life baking in the sun.) That news meant, of course, that I had to find out more. And much to my surprise, this is one fascinating nutrient.

I’ve read that Vitamin D deficiency has been linked to iron deficiency. The reason may be that individuals who are iron deficient have trouble metabolizing Vitamin D…. but I think that it is likely more of a correlation than causal relationship. Persons with fat malabsorption often have Vitamin D deficiencies, meaning that it requires some dietary fat for absorption. Symptoms of fat malabsorption include diarrhea and oily stools… (sorry again to be graphic). Fat malabsorption is associated with a variety of medical conditions including… drum roll please: CELIAC DISEASE. And, like I mentioned before, people with celiac or other malabsorption problems (like Crohns, etc.) are also very likely to have iron deficiency.

On another point high caffeine intake (300mg/day, which is equivalent to 18 oz of regular coffee) inhibits both vitamin d and iron absorption from the diet. Just another reason for me to cut back… (it is just sooo hard! Starting tomorrow!)

BUT… diet is not the best way to get vitamin D anyways. Our bodies prefer to make it from the sun. 10 to 15 minutes of sun exposure at least two times per week to the face, arms, hands, or back without sunscreen is usually sufficient to provide adequate vitamin D. Of course, this news flies in the face of the recommendations of your dermatologist- all of whom push the sunscreen. Unfortunately, if you are slathering on the sunscreen (spf 8 and higher) you’re blocking the UV rays that your skin needs to produce the required amounts of Vitamin D.
Hmmmm…. skin cancer or rickets?

Just kidding.

What makes the sunlight issue more difficult is that many of us live in Northern latitudes where the angle of the sun and weather patterns hamper our best efforts to tan. Also playing a role are season, time of day, cloud cover, and smog, affect UV ray exposure and vitamin D synthesis. For example, sunlight exposure from November through February in Boston is insufficient to produce significant vitamin D synthesis in the skin. Complete cloud cover halves the energy of UV rays, and shade reduces it by 60%.

According to the National Weather Service’s data for the period between 1951-1995. There was an average of 67 clear days per year. That’s it. 71 days were partly cloudy and a whopping 227 days were ENTIRELY CLOUDY!!!!

I am severely deficient in Vitamin D and I get outside to run every day, and I’m fair-skinned (the more pigment in your skin, the more sun it takes to make adequate amounts of vit D). It is hard to imagine how anyone here could be high without a supplement.

So, why does any of this matter?

There have been hosts of more recent studies that have linked high levels of vitamin D in the body to much decreased incidences of cancer, autoimmune diseases, and Alzheimer’s, among others. What is very interesting is that the levels needed for this kind of disease prevention are far above those needed merely for optimal bone health. These findings have led to an increased awareness of the nutrient and talks to increase the federal government’s RDA, which is currently a pathetic 200 IUs for adults under 50.

One of the most interesting tidbits for me is that Vitamin D functions more like a hormone in your body than it does like an actual vitamin. It affects your calcium absorption, thyroid, and immune system.

There are two types of Vitamin D commonly available in pill form: D2 and D3. D3, or cholecalciferol, has been found to be up to 10 times more potent that equal amounts of D2. The problem for vegans is that D3 is made from an animal source (Lanolin, which is derived from sheep’s wool). D2, on the other hand, is made from yeast and perfectly suited to vegans.

The upper limit for consumption of Vitamin D (D3) is about 2,000 IUs per day for adults. If you are deficient, your doctor will probably tell you to take more, or prescribe a 25,000 IU tablet that you take once per week.

In order to achieve the full benefit of the nutrient, many experts are recommending supplementing with 1,000 IUs of D3 per day.

Just please don’t use it as an excuse to drink more gross cow’s milk. The benefits of your increased vitamin D intake would come no where near to outweighing the health risks…. not to mention the acne and phlegmy mucus… but that is another post entirely.

Ins & Outs of Iron Supplements

Dana — Tue, 04 Sep 2007 03:36:00 +0000

Over the years I have tried countless different types of iron supplements in multiple forms. There are liquids, capsules, tablets, and soft gels. Iron is available over the counter, by Rx, in natural food stores, and at your local big box grocer. They are not, however, all created equal.

As a general rule, I avoid tablets whenever possible. They are the hardest of the forms to digest and often leave me with stomach pain. I also figure that the less my body has to work to break the product down, the more potent it will be. I’m not saying that the liquids won’t give you a stomachache! Many of them surely will, but depending on the type of iron it contains- you are probably absorbing more of it.
(For me, liquid ferrous sulphate is like taking a black enema in a bottle- sorry to be graphic.)

Here are the best Iron Supps I’ve taken (and I still have a cabinet full of others!):

1) Floradix- This stuff is expensive, especially when you consider how much elemental iron you are getting per serving. However, it works great if you are not terribly low and don’t mind the cost. They even have a version gluten and yeast free version called Floravital. Gentle enough to be taken after meals, this was my old standby in college.

2) SSS Iron Tonic- Another liquid. I ordered a few bottles along with the liquid B-complex. I was attracted by the claims that it works better than injections. It surely did work for me, right away I felt my iron come up and noticed a difference on runs within a week and a half. It did, however, give me a very constant stomachache for the month that I took it. Although there are no gluten containing ingredients on the label, the manufacturer cannot confirm that it is GF…. which was enough for me to stop taking it.

3) Hema-plex- I know, this is a tablet… but it is a good one. There are tons of beneficial ingredients packed into this little pill. It includes other blood builders such as beets and greens, as well as vitamins that enhance iron’s absorption. Another plus is that one tablet has 85 mg of iron as an amino acid chelate! Hemaplex is also wheat and yeast free, but they do not say gluten free. The ingredient in question for me is the barley grass juice, while I know that it shouldn’t contain gluten… if the grass had sprouted before it was juiced…. then there is a small chance. Uggh. Click here for a link to purchase.

4) Gentle Iron- This bottle was actually the first iron supplement that I ever purchased. I was in college and severely anemic… I couldn’t keep my eyes open in class and thought I had mono. Looking back, I’m sure it was the celiac disease, because I went through six-week stretch of everything running straight through me. Ironically, I started to cut out anything with fiber, fruit, then veggies, then nuts, and finally I was down to plain bagels. And nothing helped! I even had to go to the doctor for stool samples! (they told me I must have had a food born bacteria, but that it had worked its way out). Needless to say my track season was literally in the toilet that year. Anyways- As much as I’ve strayed, I keep coming back to this old standby. It is even Gluten-Free. Unfortunately each pill is only 25 mg…. but true to its name, it is truly the most gentle.

If you don’t have a sensitive stomach, then you can go the cheap route and get a ferrous sulfate liquid or the super cheap route and get ferrous sulfate tablets. Again, you should see faster results with the liquid, but it might also be harsher on your stomach. If the cheap iron tablets are a bit much for you, there’s always the extended release option too.

How to take Iron:

My stomach is so sensitive that I only take mine at night before bed. I left my dinner digest a little first, just because I think the less you have in your stomach the better it is absorbed.

Take the iron with Vitamin C. Try it with OJ or an Emergen-C. If you take a liquid iron, you can even make a little cocktail.

Take your iron with a B-complex vitamin and make sure it contains plenty of B12.

Do not take other minerals with your iron! Minerals, especially calcium and zinc can block iron absorption. You’ll also probably hinder the absorption of the other minerals as well. Make sure your OJ isn’t fortified with calcium. Save that one for breakfast only.

Do not take iron with coffee, tea or soy milk. Caffeine is another substance that seems to hinder iron absorption. The same has been found with the tannins in tea (black and green, not herbal), and soy protein. Try not to consume any of these substances within 2-3 hours of taking your iron pill. This is also true with absorbing the iron from food- try not to drink caffeinated beverages or teas (herbals are OK) with meals.

Better get to the afternoon run. Cheers!

Signs of Iron Deficiency

Dana — Mon, 03 Sep 2007 06:21:00 +0000

Common Signs of Iron Deficiency:

tiredness when running (hills are really hard!)
sleeping a lot and still feeling tired
muscle burning (especially quads)
elevated heart rate
reduced tolerance to cold weather
apathy (lack of enthusiasm for running or anything else)
shortness of breath
frequent infections and colds
irritability
headaches
poor concentration
clumsiness
bruising easily
craving of non-food items (like ice)

Sound familiar? Consider getting tested. If your training has increased, ask about upping your dosage if you already take iron.

Running Into the Ground: Iron Basics

Dana — Sat, 01 Sep 2007 06:40:00 +0000

Reasons Why Runners are Often Low in Iron:

1. Foot Strike Hemolysis—red blood cells are destroyed by runners’ feet pounding on the ground. You literally squish them as you strike the ground. This loss can be even more intense at altitude.

2. Sweat & Urine—small amounts of iron are lost in sweat and urine and these amounts can add up over time and worsen in hot weather.

3. GI & Menstrual Bleeding—small amounts of iron are lost due to bleeding in the gastrointestinal tract that is common with intense training/racing, while larger amounts can be lost through a regular menstrual cycle. If your cycle is causing you to lose more significant amounts of blood due to an extended length, heavier flow or increased frequency, you should report this to your doctor so that she can try to find the cause.

4. Low Iron Intake—runners who follow the traditional high-carb/low-fat endurance diet often do not consume much red meat, which is the best absorbed source of dietary iron. Many runners also tend to under eat in an effort to maintain an artificially lower weight. There is evidence that this type of calorie restriction lowers metabolic functioning and over the long term may lead to a sluggish thyroid or hypothyroidism.

Key terms:

Hemoglobin— the oxygen carrying protein found in red blood cells
Hematocrit— the percentage of red blood cells in the blood
Ferritin— the body’s stored iron (primarily in bone marrow, liver, and spleen)
Iron-Deficiency Anemia—clinically low hemoglobin or hematocrit levels
(B12 deficiency can cause another type of anemia, more common in vegetarians than meat eaters because B12 is difficult to get from a vegan diet)
Iron Depletion—low ferritin levels (for running purposes 30)

What exactly is ferritin again?

The level of ferritin in your blood is a measure of your body’s iron stores. Ferritin is a protein containing iron stored in your bone marrow and liver. Many people feel fatigued if their ferritin levels drop, even if their hemoglobin and hematocrit are OK. Exact ranges for ferritin levels are still a little controversial. You might get your test results back from a lab and they state that the desired range is 10-300. Obviously, a pretty wide-open and ambiguous guideline.

For one thing, different people seem to require different levels to feel good. One athlete may perform best as long as her ferritin is over 40, while another may require double. When fine-tuning for performance enhancement, it is best to track ferritin levels over time, that way you can get a baseline level of what might be normal for you. Unfortunately, few people think to go in for blood tests when they are feeling fine. Some sports medicine docs and coaches like an athlete’s ferritin to be above 100. It is commonly accepted in the running community that a score under 30 means you should be pumping some iron into your system, in whatever form necessary.

Serious female runners should have their iron levels checked a minimum of twice (preferably four times) per year. Competitive male runners should be tested annually, and those with a history of iron depletion (or vegetarians) should be tested at least twice per year. To ensure consistent results, always have your blood tested before running (i.e., when you are well-hydrated), because dehydration will make your iron levels appear higher than they are. Again, the major iron status tests of interest to runners are: hemoglobin, hematocrit, red blood cells and ferritin. And, depending on how savvy your doc is, you may have to specifically request the ferritin to be checked. Unfortunately, it is still not a commonly performed test by many family practitioners.

More on iron supps and common signs of deficiency in another post.

Stoking the Fire…. Iron Scores

Dana — Sat, 01 Sep 2007 06:24:00 +0000

Today I got the results from the team blood test we had on Wednesday.

Drum roll please…..Ferritin is 16!*

Because low iron is so prevalent in distance runners, (why? see my post entitled Running Into the Ground) we screen our athletes twice a year with blood work from the health center. The woman who stuck me with the needle asked me what year I was when I got on the table. She was embarrassed when I told her my age and that I’m a coach. At least she complemented my veins.

Unfortunately, I couldn’t wait that long to get tested. At the end of June I began a pretty steep decline. I went from feeling somewhat decent on runs, to starting to get tired, to having an allergy induced asthma attack while running on Wildwood. That hasn’t happened to me in a few years- and it has only happened 4 or 5 times in my life. I do know from experience (and the allergist) that it is brought on by exposure to the allergen AND severe fatigue. Since the allergy tests revealed that I am basically allergic to Oregon, or at least all of its trees and grasses, I knew that fatigue was the main culprit.

The heat over the fourth of July in Ashland only made me feel worse, so I emailed my Endo in Houston to ask for some blood work. I was overdue in checking my thyroid’s status anyways. The only red flag from the results was, of course, my iron. Ferritin was 6. Again. Again! I thought the gluten-free diet was supposed to be helping, but apparently my intestines are still not in shape.

So it has been 5 or 6 weeks of stomachaches now. 5 or 6 weeks of reading gluten-free forums and message boards in search of some kind of help from the celiac community about how to overcome the chronic anemia. I have known about my iron issues since college. I was even sidelined my sophomore track season with chronic anemia. At least now the malabsorption problems have been somewhat explained. (i.e. in people with celiac, gluten destroys the microvilli which line the intestine to aid in capturing nutrients).

I’m trying to figure out how to go about getting a drip or even injections, but I am without insurance…. so who knows. I am just anxious to get rid of the stomach pain and GI problems again. I can only liken it to eating a steaming bowel of hot buckwheat**….EVERYDAY!!!

* The level of ferritin in your blood is a measure of your body’s iron stores. Ferritin is a protein containing iron stored in your bone marrow and liver. My highest recorded ferritin has been 18, the lowest was 5. Under 30 is a red flag. Ideally, much higher is better for performance.

**I actually did this by accident 3 weeks into my gf life- thought it was the cream o’rice cereal. Paid for dearly for it for three days afterwards.