Posts Tagged ‘fatigue’
Finding Partners in Health
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!
Vegan Athlete Tips: Brendan Brazier
After suffering an intense bought of stomach pains, cramps, and intestinal distress due to a “non-constipating gentle” iron supplement on Monday night… I’ve been re-reading everything I can about vegan iron sources and blood building.
I found the article bellow on a website called In a Vegetarian Kitchen. It’s an interview with Brendan Brazier, the vegan triathlete and author of one of my favorite books: The Thrive Diet.
The book is filled with great recipes and advice that I use often as a resource. He has some great recipes and really advocates gluten-free eating.
I agree with the underlying principles that Brazier presents, especially his explanation of stress.
I talk about the cummulation of stress often with my athletes. It’s not just stress from training that takes a toll on the body, but all types: nutritional (from eating the wrong foods or not enough), emotional (from work or relationships), and environmental (from toxins and polluntants in both our homes and the outdoors). Basically, the idea is that the system is overwhelmed by the sum of all these types of stress… and you can’t handle enough good stress if you are up to your neck in bad stress. This is why it’s nearly impossible to have a great workout or race after a devasting breakup, or at the end of finals week.
Check out the link bellow for Brazier’s tips on vegan eating as an athlete:
So Long Stevia- from VegNews.com

I was alarmed to find this article about Stevia on the Vegnews website. I eat a fair amount of stevia… ever since the non-bitter types came out a number of years ago. My favorite brand is NuNaturals out of Eugene, Oregon. It really has the cleanest flavor of any that I’ve tried over the years. The maltodextrin doesn’t seem to have any adverse affects on my stomach at all. The new Truvia, however, doesn’t sit as well. I appreciate them trying to cut stevia with Erythritol to give it that granular sugar-like quality, but my system doesn’t do well with sugar alcohol even though Erythritol is much more gentle on my system than Xylitol.
An aside: Erythritol & xylitol, are natural sugar alcohols so they are digested differently than regular sugar and don’t produce the pronounced blood-sugar spike and insulin response… too much of which is linked with diabetes and weight gain. Erythritol is known for having less gastric side effects than other sugar alcohols because it is absorbed in the small intestine while xylitol is absorbed in the large intestine and larger quanities often lead to gas, bloating and a laxative effect. Erythritol, has 5% of the calories of table sugar (.2calories per gram vs. 4 calories per gram) and 70% of the sweetness. So it is almost calorie-free
But back to the sweet stevia leaf…. after reading this article I want to figure out how it affect fertility in women, not just men. ugh. I really don’t want to give up my little white packets. They make cocoa & tea so much more delightful.
READ THE FULL STORY ON VEG NEWS.COM
Does this sugar stand-in stymie hopes for fertility in the future? VN’s resident nutritionist studies the sweet substitute.
By Ilyse Simon
Confused about whether or not switching from sugar to stevia might hurt your chances at parenthood? Your nutritional debate is understandable. Though the Food and Drug Administration approved stevia in December, there’s still some question about how much is really safe, especially if you’re trying to conceive. The short answer is that adding stevia to a cup of tea or coffee each day won’t compromise your health. However, stevia is worth scrutinizing if you plan to use it often or in large quantities.
Stevia is a shrub native to South America with leaves sweeter than white sugar. It’s calorie-free and one of just a few alternative sweeteners for people with diabetes, and the FDA has designated stevia Generally Recognized as Safe. (This is controversial because there are many products deemed “safe” by the FDA that I would never consider consuming, and the FDA has a history of protecting big agribusiness over human health—but there’s an element of truth to this one.) Stevia has been used in other countries for centuries without ill effects. Used to sweeten yerba mate in Paraguay and in Japan to sweeten pickles since the 1970s, stevia—in small quantities—has not been proven harmful. The main concern is that if we mass-market this plant extract as we have with soy, stevia could become a ubiquitous ingredient in everyday packaged foods. If your energy bar, smoothie, tea, and dairy-free ice cream are all sweetened with stevia, that might be more than is considered healthy.
North Americans, in general, still think more equals better, and tend to go to extremes when we find something we like. Again, it’s similar to the soy story: Asian cultures eat moderate amounts of soy daily in whole-food forms without negative consequences; Western cultures have processed and refined soy into isolated protein components, added it to highly processed energy bars, and continue scarfing them down like health foods. This is where the problems lie. The specifics on stevia show that high amounts affect male reproductive health with reduced sperm counts and possible infertility. In some laboratory studies, stevia acts on a cell’s DNA to cause unwanted mutations and may promote cancer. In other studies, large amounts of stevia interfere with normal carbohydrate metabolism. Recently, the Center for Science in the Public Interest lists stevia as an additive that people should “try to avoid,” but maintains that small amounts are probably safe.
The bottom line is that a little is probably fine, but a lot is not. That’s advice for almost any situation. One or two cups of coffee with stevia is not raising concern amongst researchers. It’s the scenario where stevia sweetens diet soda, fruited waters, and every piece of chewing gum stuck to your shoe that is of concern. Keep your diet clean, eat lots of fruits and veggies, go ahead and ditch the tighty-whiteys, and your fertility will likely be fine.
Behind the Scenes… “You… The Distance Runner”
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…
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.
Signs of Iron Deficiency
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.



