A little background on myself — I’m someone who likes to stay active. I enjoy working out, running and even teach spin “on the side”. Feeling tired isn’t unusual for me. However, I discovered this spring that the rundown I felt was something different.
I’ve been working with a run coach with Gotham City Runners for the past year. He noticed some unusual symptoms based around my complaints of not being able to finish workouts. A clear example of this happened one night during our track workout. As I was running, my legs got heavier and heavier to the point where I could barely lift my them to run. Even though my legs were tight (not unusual), he had a feeling something was else was wrong and insisted I go to my doctor to check my iron levels. It turned out, something was wrong; I was anemic.
Anemia is pretty common in athletes, particularly females, and actually very hard to diagnose. The symptoms of anemia mask itself as over training. Some basic symptoms include:
– Slower response to recovery from workouts
– General fatigue
– Muscle heaviness
– Shortness of breath
Anemia is a lack of iron in the blood. Iron is a major component of red blood cells or hemoglobin, which is the way oxygen is carried through the blood to various muscles and tissues that are used in aerobic activity. If you lack iron to carry oxygen, then your muscles aren’t getting what they need to work properly.
A simple blood test by my doctor showed that my levels were shockingly low (as in off the scale low). Normal ferritin (the iron mineral) should be a low of 12 for women. I was a 6! And iron saturation should be a minimum 45%, I was at 15%! Needless to say I was low for the average woman, let alone trying to train for half-marathons and a fall marathon.
The good news about anemia is that it’s easy to correct. For me, it required a change of diet and taking iron supplements. I started with diet changes of including spinach, beans (black and kidney), and red meat. It wasn’t that I don’t eat these foods for specific reasons, I just preferred other options. At least I was lucky it was summer and there were loads of BBQ (thanks hamburgers). Due to my extremely low levels, I also added in an over-the-counter supplement as well. After the initial diagnosis, I had to scale back on exercise and cardio (no cardio 2-days in a row, reduction in time spent in aerobic exercise in general). My coach recommended this change in routine to not deplete my already low levels of iron.
The bad news is that it does take a while to get your iron levels up. It took me over 4 weeks even begin to notice a change in energy. However around 6 weeks of diet change and iron supplements I felt a significant difference; my running was coming back (specifically speed), my legs recovered faster, and I sounded better-more energetic. A simple blood test confirmed my levels were way up!
Now that I identified the problem, I’ve had to modify my marathon training and learn new routines. For starters, there’s a constant test of my energy levels; can I run a certain distance, hit a certain pace, and recover enough to do the next workout. My awesome coach recognized this and modified my training. He held me back in beginning and until I showed more energy, then slowly added on distance. Instead of normal marathon training where you have up weeks and down weeks, I just went steadily up each week to avoid over working my system (and also modified since I started training late). I still don’t do cardio workouts back-to-back to avoid depleting too much energy overall. As a runner, I have my set routines for eating, which also had to change. My pre-race meal of pasta now includes red meat (before I would have had it plain or with chicken) to help my iron levels. I also take an iron supplement before a run to help me from the start.
I’m pretty sure I have been anemic for years and never knew it. Looking back, I think some of my past issues, which I assumed was over training, was actually anemia symptoms. It’s been a struggle to come back though – frustrated at the slow progress, being forced to scale back on activities I enjoyed doing, and then being 6 weeks behind to train for a marathon. But I’m glad I had someone who realized what was wrong and knew the difference of “tired” vs. “run down.” I know this is a condition I’ll constantly have to be aware of and treat.
My advice: listen to your body. See if any of the symptoms match up (for me, it was the lack of recovery and heavy legs). If you are experiencing unexplained fatigue and/or a decrement in performance that has persisted for several weeks, a blood test is good initial screening for anemia.
Through my experience, I have learned a few key things about anemia and general iron intake. There are many things inhibit the absorption of iron and what helps speed up that process. Some advice is below:
Food that inhibits the absorption of iron (if you’re eating iron rich foods, avoid the below):
– Red wine
Foods that helps with the absorption of iron:
– Acid rich foods (i.e.: tomatoes)
– Citrus (i.e.: lemon juice)
– Vitamin C
Basic over-the-counter iron supplements can upset your stomach. If you have any tummy sensitivity, I recommend getting the slow-release iron. This is gentler on your stomach and won’t cause issues.