23 replies to this topic

[runninguphill]

Hi, I've been reading some of the older threads on this topic but wanted to start a new one as I've just got my iron studies and my doctor was very surprised at how low all my levels were. My ferritin was 6 and iron 2. I am female, mostly vegetarian (I do eat fish these days) and have had anemia on and off for most of my adult life (and possibly as a teenager but never diagnosed). Last year I was diagnosed with Grave's Disease (an autoimmune disease) and they did a blood test for coeliac disease which came back positive. I thought that I finally had an answer for my anemia. Then this year I finally had the gastroscopy (the definitive test for coeliac) and I don't have it (but do have stomach ulcers). Last year when I was on a gluten free (and taking iron supplements) I had normal iron readings and stopped taking the supplements.
I should have worked out that I was anemic as I've been very tired lately (and had tingling in hands and feet and very pale around eyes, not able to run fast at all, etc). I know that many people would blame the vegetarian diet (my husband included) but I'm fairly sure that I had the symptoms of anemia as a teenager when I ate red meat quite regularly. I would love to know why some people get it. Does it have any connection to running (I only average about 20-30kms a week). Anyone have any ideas?

[getfitfast]

Hi, I'm also vegetarian and after a recent 30Km run (my second only), I was shattered for the rest of the week. Very tired and all wanted to do was sleep and eat lots of food. The last two weeks I have pulled back most of my training - about 3 (10K) runs in all. I would normally do 50-60Km per week, plus two sessions of bootcamp. Asked my online running coach and he indicated probably low in iron & B12. Last 4 days I have started taken an iron supplement and feeling the difference. It also be a result of taking a couple of weeks off. My challenge I won't get much training in before the Blackmores HM...

Cheers

[kathmandu]

Hello,

Ive had troubles with low iron too. From my understanding peoples ability to absorb iron varies greatly so some people will always have issues and others not. Theres lots of theories about complete diets that will enable your body to increase its absorption, such as raw diets and eliminating grains. But i dont have any experience with them first hand. I do believe though, that some people can exist quite healthily on low stores, so i do necessarily think you need to be aiming at a particular feritin number, just try to get to a point where you feel healthy and full of life, and then aim to maintain that.

I was a meat eater who had low iron and managed to change to being vegetarian, then vegan and now i dont have any issues at all, so dont throw away vegetarianism as it definitely doable without meat.

I didnt use supplements at all, i just calculated my iron everyday and aimed for 30mg. For about 4 months i managed 25-30mg per day and that was enough to lift my feritin by 16 micrograms. The other things i did were to stop drinking tea (reduces absorption greatly) and had vitamin c with every meal (ie either a capsicum or an orange or juice). If you need any more help calculating your intake or choosing foods just sing out.

Now i just consciously try to eat iron rich food, but i am nowhere near the 30mg, id probably only have 18mg i spose, but that is enough for me to keep my levels constant. And i can drink tea again, yay. I get them checked every 3 months just to be sure.

Yes i definitely think it has a lot to do with running. Running tipped me over the edge from being just naturally a bit low, to having to take action. They say in the literature its because of each footstrike causing small amounts of bleeding. But i also presume (not that i am any sort of medical professional) that the increase in training results in greater blood volume and hence a greater requirement for iron. I dont have any experience with the other diseases you may or may not have, so i cant comment there.

Anyhow good luck with it all, but please dont feel as though the vegetarian diet is to blame. I strongly believe you can manage it without meat (and without supplements if you chose).

All the best

[mjail]

Ever since, I did my first complete blood test in my early 20s (15yrs ago), my haemoglobin levels were on the lower side but still considered OK. However, each time I was pregnant (3x), my iron stores got progressively worse and had to be on iron tablets. But I stopped taking them as soon as I gave birth each time.
Then a year ago after my youngest was 2 years old, I started getting really light headed and felt nauseaus frequently and on getting my blood pressure taken all was fine so decided to get my blood tested and my ferritin was considered borderline but iron was at 6. I think the normal iron levels are 11-27.
All the doctor told me was to take 2 iron tablets a day which I did for 6 mths and then felt so much better and totally stopped it. But having taken up running abt 5 mths ago, I have taken iron tablets on and off, which I guess would be avg once a week and just realised it probably is not enough. I have always eaten well so diet was not the cause of it.

But as PsychoChicken said, take foods richer in iron (spinach is a good one) and have a glass of orange juice with your meals to help absorption.
Actually, your thread has reminded me that I should have my iron levels checked out again as I am one of those who dread seeing the doctor and tend to leave things too late. I have not been feeling my best and it just occurred to me last night that my iron levels are most likely on the low side.

I hope running is not a major cause or I know hubby will strongly discourage me from running. As it is, he thinks I am overdoing it.
Did you ask specifically for the Grave's Disease test ? I will have to google it up to see if I should be concerned about that myself as I am unaware of it.

[BoneyChic]

PsychoChicken, on Aug 29 2008, 08:52 AM, said:

Yes i definitely think it has a lot to do with running. Running tipped me over the edge from being just naturally a bit low, to having to take action. They say in the literature its because of each footstrike causing small amounts of bleeding. But i also presume (not that i am any sort of medical professional) that the increase in training results in greater blood volume and hence a greater requirement for iron. I dont have any experience with the other diseases you may or may not have, so i cant comment there.

I experienced the same issue as PsychoChicken - naturally low iron levels but running has caused them to drop way too low. Always tired, suffering severe headaches, being absolutely shattered after training and to the extent that I had to force myself to eat as I had lost my appetite. My dietician gave it a name of "runners anaemia" and described what happens when I run. I now take an iron tablet every morning and a dose of metamucil at night (I get constipated from the iron tablets). Energy levels, appetite all on the increase - headaches on the decrease. All good.

[mikel]

If you felt better eating a gluten free diet i would continue to do so, even though the coeliac test came back negative. You may not be allergic to wheat but if you felt better eliminating it from your diet you may still have an intolerance to wheat and other gluten containing products and only able to tolerate small amounts occasionally. An intolerance to wheat could cause stomach ulcers, as could other things like medications and bacteria.. Inflammation in your gut would impair the absorption of nutrients in general.

[runninguphill]

Hi again, thanks for the replies. Mjail - I'm not sure that the Grave's Disease (over-active thyroid) is necessarily linked to low iron, the doctor just ran a heap of blood tests at the time which picked up both. Grave's Disease is an autoimmune disease as is coeliac disease and often people with one autoimmune disease will have another.
What iron rich foods do other vegetarians eat? I know about leafy greens, apricots, berries. Are there any that anyone feels have had a significant impact? I am thinking about a return to the gluten-free diet but must admit that it has been nice (after being on it for a year) not to have to always read labels and go without some of the time.

[kathmandu]

runninguphill, on Aug 30 2008, 05:31 AM, said:

What iron rich foods do other vegetarians eat? I know about leafy greens, apricots, berries. Are there any that anyone feels have had a significant impact?

pumpkin seeds, beans, lentils, tofu, toast, fortified cereals (i only ate them while i was trying to get mine up), milo (same i just used it to boost my levels), dried apricots, dates, figs, prunes, almonds, chick peas, rice, baked spud, green leafy's.

Tricks i used were to have a fortified cereal for brekky (usually sustain or allbran) with pumpkin seeds and pureed and soaked apricots or prunes on top. Then lunch had a green salad with seeds, nuts or figs/dates. Or tabouleah. Or hummus. Then dinner was something based around lentils or beans and a spud. And then a couple of glasses of milo during the day and snack on pumpkin seeds, dates and figs. I just looked at the websites below and only really ate stuff with a decent amount of iron, otherwise the food volume would have been too much and i would have turned into a porker.

Actually reading my first post i sound like a bit of a liar. I do the raw food thing at times, what i actually meant was i wasnt doing it while i was trying to increase my iron stores. But now my body happily sits in a good range and so raw food is possible. I just know that some people believe you can increase your bodies ability to absorb iron by going 100% raw, but i have never really played with that concept on my own body. Although i guess the fact that i can maintain it now and eat mostly raw may indicate that happens. But im not sure. Anyway thats probably not relevant to you, i just wanted to clear up what i meant.

Anyhow websites i found useful were.....
Veg Foundation factsheet on iron
Iron Content in some foods
some more iron content stuff
and a bit more

Oh and one other thing. It does take quite a while for your body to absorb iron, so dont expect immediate results. It takes a few months of eating high iron foods to see the results.

Good luck

[orlando]

runninguphill, I don't think I can add anything to the excellent nutritional advice you're getting, but I was wondering what treatment you've had for your stomach ulcers and if you've had checks to see that they've healed. If not, there could be ongoing blood loss from your stomach contributing to your low iron levels.

[slowmo]

PsychoChicken, on Aug 30 2008, 09:06 AM, said:

pumpkin seeds, beans, lentils, tofu, toast, fortified cereals (i only ate them while i was trying to get mine up), milo (same i just used it to boost my levels), dried apricots, dates, figs, prunes, almonds, chick peas, rice, baked spud, green leafy's.

I knew toast was a wonder food !

Thanks for posting this info and the links PsychoChook - it's really useful. I'm another with a long history of (I assume) naturally low iron levels and I've wondered if running longer distances might require a bit more thought about my diet.

slowmo

[maryclaire]

PsychoChicken, on Aug 29 2008, 08:52 AM, said:

Yes i definitely think it has a lot to do with running. Running tipped me over the edge from being just naturally a bit low, to having to take action. They say in the literature its because of each footstrike causing small amounts of bleeding. But i also presume (not that i am any sort of medical professional) that the increase in training results in greater blood volume and hence a greater requirement for iron. I dont have any experience with the other diseases you may or may not have, so i cant comment there.

I think you are right about the running being linked to the low iron levels. Interestingly, every urine test I have had since starting running has shown traces of blood - which worries my Dr but I just think is due to exactly what you have mentioned.

[runninguphill]

PsychoChicken, Thanks so much for the great advice and the links. It is reassuring to know that anemia affects the vegetarian, vegan and meat eating population equally. It is surprising, however, that even my doctor thinks it could perhaps be linked to my diet.

orlando, on Aug 30 2008, 09:24 AM, said:

runninguphill, I don't think I can add anything to the excellent nutritional advice you're getting, but I was wondering what treatment you've had for your stomach ulcers and if you've had checks to see that they've healed. If not, there could be ongoing blood loss from your stomach contributing to your low iron levels.

I'm back on medication for the stomach ulcers as the doctor thinks this will provide protection whilst on the iron. The ulcers were not bleeding when I had a gastroscopy done a few months ago. I go back to have them checked in December and they will probably repeat the gastroscopy. As for the medication: it gives me diarrhea and the iron gives constipation (and that is after one day of taking both).

[runninguphill]

What a difference some iron supplements have made. I had the best run in ages this afternoon - a hilly one, nice steady pace and the heart rate average was 149 (I've never had it that low on this route). I have a big grin and feel pretty motivated right now. Interestingly it seems that the stomach ulcer medication (which inhibits acid in the stomach) could be the cause of the anemia - apparently the stomach needs acid to absorb iron (I read this on the net). The stomach ulcers were probably caused by a thyroid medication I was on (according to the pathologist)- talk about a vicious cycle.

[mjail]

Glad to hear that you feel so much better, runninguphill !

As for me, I have an appointment with my doctor next Fri to get the results from the blood test and kidney scan. Apparently, I still have blood in my urine which occurred about 4 years ago when pregnant with my youngest. The blood is not visible to the naked eye and hence, I was not alerted. Doc recommended a kidney scan and I may have to see a urologist depending on the results.

Have been taking one iron tablet a day and feel slightly better. My first half marathon is coming up this Sunday and I do hope I'll be feeling really good on that day.

[twosheds]

Hi
Are you being treated for Graves Disease? My husband has a family history of this and what starts out as an overactive thyroid can turn to an underactive thyroid - which could explain fatigue and maybe some of your other symptoms, I saw this happen to my sister inlaw- she was normal- then became over active-after having kids- complete transformation in bodytype - she actually looked great for awhile but then became grey looking and shaky with very protruding eyes. This was treated and then suddenly her thyroid just died- gained 10kg, felt tired etc until they realised what had hapened. Treated with thyroxine - all sorted again
My daughter has underactive thyroid ( Hashimotos - also auto immune) and it's symptoms are very insidious and non specific- but Im sure it would all but impossible to run well and feel good if your thyroid is not functioning properly.
Just a thought.
Good luck
Two sheds

[runninguphill]

I am very happy to say that my thyroid levels are normal at the moment (euthyroid) and have been off the medication for about a month now so I'm hoping the Graves has gone into remission. I have read (on the net) that Graves is linked to iron deficient anemia and the two do have a lot of similar symptoms. Do you know whether this is true twosheds? I was worried at first when I was getting really tired that the thyroid medication was making the thyroid underactive but it was all good in that area (and now am off the medication anyway), but iron was really low.
Twosheds your sister in law must have had radioactive iodine to kill off her thyroid. It sounds like she has had a bad time of it. I have been pretty lucky. In fact I credit running with me being so aware of my heart rate and noticing when it and my fitness were affected so that I got to a doctor quite quickly and my doctor was onto it straight away - I've heard some terrible stories.
The strange thing is that I am the only one in my family to have a thyroid problem and I'm also a lot fitter than the rest of them.

[twosheds]

It makes you wonder what causes it- but knowing your body well as a runner must have been most valuable. My daughter had a very bad time with Hashimotos- i suspect it miay have started out as Graves also. She was only 15 when diagnosed ( very young for this apparently) and it took quite a while for everyone to work out that she needed to have thyroxine levels up near the top of the "normal"range in order to feel good. At first they just her just inside the normal range and we had some really serious problems.
Sorry i dont know about the iron stuff- just really knew third hand about my sister in law- and saw the effect. But saw my daughter annd wouldnt wish that on anyone.
You seem like you have things in hand- Good luck with it all
Twosheds

[robbo22]

A few things i've noticed in this thread.

1. Take it from me - a lot of GP's aren't so clever with things that fall outside of "tears, fears and smears". (there's the physicians exam, ranked and scaled. those that pass it get to be called ____ologist, those that don't get to be called GP [or they can stay in the hospitals as a registrar, but never a consultant]), so be cautious about accepting a GP's word as final for anything chronic that is going to impact your life significantly

2. Most runners do have a bit of blood in the urine, because running "shakes" all your organs pretty much, and with an empty bladder collapsed in on itself somewhat, and the jarring of running, well, think of it as chaffing. Lore of Running taught me that.

3. Baked beans are natures super food. A big tin of it comes in at 300kcal and is filling, thus, good for the waistline, has heaps of iron, low GI, etc.

4. Most iron in foods aren't absorbed - meat source iron has a greater absorption % than non meat source... so the vego-anaemia link exists, and probably excusable to jump to them conclusions.

5. I still wonder why people feel great when they take iron supplements, yet stop taking them... constipation is a side effect sure, but you can combat that with more fibre (i dont know first hand). Weet-bix and baked beans, all the way

[orlando]

robbo22, on Sep 20 2008, 11:12 AM, said:

1. Take it from me - a lot of GP's aren't so clever with things that fall outside of "tears, fears and smears". (there's the physicians exam, ranked and scaled. those that pass it get to be called ____ologist, those that don't get to be called GP [or they can stay in the hospitals as a registrar, but never a consultant]), so be cautious about accepting a GP's word as final for anything chronic that is going to impact your life significantly

Robbo, you're being a bit harsh and condescending to GPs there - and you don't really understand the system. You don't get to be a GP by failing the physicians exam, you get to be a GP by passing the GP exam.

In fact, the only thing you get to be by passing the physicians exam is a Senior Registrar, and then you have more subspecialty training and maybe more exams before you're a consultant.

And even then that only covers the medical specialties. Surgery, dermatology, opthalmology, etc... are whole other ballgames. All the various ____ologies have their own colleges with their own requirements. The college of General Practice is no exception.

[mjail]

robbo22, on Sep 20 2008, 11:12 AM, said:

2. Most runners do have a bit of blood in the urine, because running "shakes" all your organs pretty much, and with an empty bladder collapsed in on itself somewhat, and the jarring of running, well, think of it as chaffing. Lore of Running taught me that.

5. I still wonder why people feel great when they take iron supplements, yet stop taking them

Well, when I first had blood in my urine, I was not running at all but yes, I do understand that it is not uncommon for runners.
As for not taking the iron supplements - I have never been a believer in popping pills. Always felt that as long as one has a balanced diet and does everything in moderation, one should be fine. But now I find that there does not appear much I can do of increasing my low iron stores and may have no alternative but to take an iron tablet a day. I suppose the situation has worsen given that running has also become an exception to my moderation rule.

I understand your comment not taking the GPs word as doctrine but don't you think your words were a little too strong ?
Besides, even two equally qualified specialists with years of experience may have differing views. And people usually get 2nd opinions, anyhow.
Robbo, aren't you a medical student ? Shouldn't you accord some respect to your fellow Seniors who opt to remain as GPs and not specialise in any field ? GPs are the first point of contact and should they feel it warrants further tests/advice, a referral will be done to the appropriate specialist.

Edited by mjail, 20 September 2008 - 06:57 PM.

[runninguphill]

Iron tablets can indeed have very nasty side effects (even with a high fibre diet) but as I have the opposite symptom from my other medication it seems to be balancing out more or less.
As for the comments about GPs, I have a lot of respect for my GP. Also related to a GP so I am biased. I think the important thing I have learned is that you need to ask the right questions and not be afraid to ask for more information, also to mention anything that might be relevant to your own health. My GP has rung me at 7.00pm before when she is still at work to discuss some results and earlier in the year when my son had a mallet finger the hospital treated it all wrong, I saw the GP she diagnosed it straight away and splinted it, had to go back to the hospital to get the right splint and I ended up telling the young doctor what it was and how to treat it. He then got out a medical text book and read the entry on mallet finger to me!

[bluey2008]

runninguphill, on Sep 21 2008, 06:55 AM, said:

Iron tablets can indeed have very nasty side effects (even with a high fibre diet) but as I have the opposite symptom from my other medication it seems to be balancing out more or less.
As for the comments about GPs, I have a lot of respect for my GP. Also related to a GP so I am biased. I think the important thing I have learned is that you need to ask the right questions and not be afraid to ask for more information, also to mention anything that might be relevant to your own health. My GP has rung me at 7.00pm before when she is still at work to discuss some results and earlier in the year when my son had a mallet finger the hospital treated it all wrong, I saw the GP she diagnosed it straight away and splinted it, had to go back to the hospital to get the right splint and I ended up telling the young doctor what it was and how to treat it. He then got out a medical text book and read the entry on mallet finger to me!

How is the iron going for you now runninguphill? And the Graves?

I had Graves and hyperthyroidism about 6 years ago and it was treated with neomercazole for about a year. Once it was fixed, I felt so so much better. I wish that the disease was more commonly known, or at least GPs would check for it more regularly, because a lot of people, including myself, go for a long time before it is picked up.

Anyway now I was diagnosed with low ferritin (7) and it explains so much about why I have been so exhausted lately - the last few weeks I have been skipping dinner because I've been too tired to cook, which of course only compounds the problem.

So it's no more skipping meals and onto red meat, green vegies, mushrooms, tofu, salmon, and iron tablets for me!

[runninguphill]

Back to the doctor next week for a proper check, but I am feeling good. The iron tablets have had a huge impact on my running as I am back to my previous pace and can complete a long run quite comfortably. I would definitely stay on top of the iron as I now suspect that the Graves and iron deficiency go hand in hand (they certainly share many similar characteristics). I was very lucky that my GP had a few patients with thyroid disease and she tested for it straight away when I described having heart palpitations to her.
Thanks for inquiring Bluey, take care, the tiredness always sneaks up on me, I generally put it down to work, family,etc. The good thing about being a runner is that it has helped me to notice when my fitness seems to be waning (I just need to remember that there is often a reason and to get it checked out).

[twosheds]

Glad you are feeling better. Isnt it great when you (for whatever reason- injury, illnesss) start to run well again!
Two sheds