19 replies to this topic

[TashyTuffNut]

This is my plea for help (haha, yes I am being a little dramatic).

I have been running for about 10 years, racing halfs for about 3 and will be doing my first full marathon in just over a week.

I have an ultra marathon booked in for 22nd September so I really need to sort this issue out.

Have been vegetarian all my life and have never had any issues. However after increasing my weekly mileage about 5 months ago, my iron levels just plummetted. About the same time my menstrual cycle stopped - which you would think would actually increase my iron levels.

Anyway, 3 months ago the doc told me to start taking iron supplements. Got my iron tests back today and my levels have gotten worse!

I have tried to add every iron rich food I can think of (non meat) to my diet and it has done zilch! I'm eating oats, amaranth, eggs, spinach, dried fruit - especially peaches, raisins and apricots. Have cut down on my tea and coffee consumption - only two cups of coffee a day and never with food.

The doctor's advice today was to double the supplement dose I'm currently on. This doesn't give me high hopes.

Does anyone have any words of advice? The low iron levels really are affecting my energy levels and have started impacting on my thyroid which is also affecting my energy levels. I really want to get on top of this issue before my ultra.

Thanks in advance.

[twosheds]

Hi Tashy,
Id be  getting back to the Dr. I'd also be concerned about the disappearance of the menstrual cycle if it continues. This  can really impact upon your bone strength as oestrogen has a really important role in building of bone. If it continues it can have really long term consequences. Hows your weight? Are you underweight? Do you eat enough?  There are sometypes of anaemia where the iron is unable to be absorbed but I dont really know anything about this. Im sure we have some medical people among us who can shed some light.
Twosheds

[TashyTuffNut]

Thanks for your reply twosheds. Yeah I went to the doc today, but all he said was to double my supplements and re-test in 6 weeks.

I just feel really annoyed that in the last 6 weeks since my last test I have not only been taking supplements but taking great care with my diet and it has made absolutely no difference.

The loss of the menstrual cycle is attributable to weight loss and increased training (am currently running between 80-100km a week). The doc is managing that and as I refuse to cut down my training at the moment, he assures me the pill will keep my oestrogen levels ok (am having them tested regularly too to make sure).

I have lost 10kg in the last 12 months but I'm not underweight. My BMI is smack bang in the middle - I'm 65kg and 171cm tall.

I feel like I'm eating ALL day, just to try and get as much iron into me as possible. My day is structured around 3 meals and 2 snacks (which are probably verging on being 2 small meals )

I just feel at a bit of a loss as other than supplements or devouring a steak, the doctor didn't seem to be any help at all.

[TopEndChick]

maybe try a dietitian or naturopath? i know there are other nutrients which are needed for the iron to be absorbed - i think its zinc and calcium (possibly potassium & magnesium?) but dont quote me.... also, i'd be checking that the supplement includes folate as that is essential for cell function.

goodluck...

Edited by TopEndChick, 21 June 2012 - 02:27 PM.

[Sunset]

yes, might be worthwhile having a couple of appointments with a sports dietitian or nutritionist.  Food combining may be the key (and I think it is vit C that is needed to absorb iron).

Also, you might need to change to a different iron supplement?  I was on a liquid one called Floradix a while ago.

[slow]

My wife is a dietitian and has suggested seeing a sports specialist (to confirm recommendation by sunset).  But in the meantime it is important to eat eggs, nuts, seeds, or legumes at more than 200gm every day eaten with a fruit or veqetable (which assists assorption).  At the same meal time avoid added fibre (things like wheat bran), calcium foods and phytates (tea).  Iron supplements to be taken with the protein foods and a glass of juice (not with breakfast as cereal and dairy both affect assorption).  

Making big assumptions but loss of menstrual cycle suggests you may have reduced your body fat too far?? Just a thought.  

Good luck the Ultra.

[Freesoul]

Hope you get this sorted Tashy,
My brother-in-law was on an iron supplement which was just passing through him (literally - he could see it in his poo!). I think it was ferro-gradumet.
Yeah, us runners can be susceptible to iron deficiency. Something to do with the red blood cells getting smashed in the capillaries of our feet, esp when doing high mileage.
I guess you know to take iron supps with vit c for better absorption.
Best wishes, my heart goes out to you. You can get over this little hiccup and run your best in your marathon and ultra.

[Wedgetail]

If your haemoglobin doesn't sort out soon with the supplements you should get a second medical opinion possibly from a specialist gastro-enterologist.
Could be you are not absorbing the iron from the gut. There are a few bowel problems that prevent absorption of nutrients.
You may be absorbing the iron but losing blood at a greater rate.  Have you had a test for foecal blood? Blood loss anywhere other than the bowel is usually pretty obvious.
Or, your body may have the iron etc but is not manufacturing haemoglobin for some reason.
I would be surprised if running is the cause but trying to run if anaemic will sure let you know something is wrong.
It may be something simple but you need defite answer as to why the problem exists.  Ask you doctor if a referral would be a good idea.

[julz83]

i very rarely post in coolrunning these days but just happened to have a quick look and saw this thread and thought id add my 2 cents.

tashy you are pretty much identical to me. i have been a vegetarian for 10+ years, have only just started eating seafood again for the last 6 months but it is more for enjoyment factor and only when i eat out rather than at home. doesnt help much with iron levels though.

i have been been running for the last 5 1/2 years and have battled low iron levels on and off and had my share of iron injections.

In april just gone i ran my 4th marathon just after getting married in march. i havent had a period for the last 6 months (coincided with heavy training and dropping a few extra kg's). At 175cm and 56kg i know im at the lower end of my bmi.
Im on iron tablets (which i hate due to constipation) and try to get as much iron in my diet as possible but at the end of the day non-heme iron is always going to be inferior to heme iron.
I just had another blood test 3 days ago and my low iron stores persist. I was booked in for an iron infusion next tuesday but have had to cancel due to a pretty hectic schedule.
I am looking at trying to conceive as soon as i can but i know that i need my iron levels to shoot up, the infusion is definitely an option and i will hopefully try to book again soon (its the equivalent of having a whole course of iron injections in 1 go)

tashy can i suggest that your marathon training combined with being a vegetarian and a female are a direct cause of your iron deficiency. I know it sucks feeling fatigued but while you put your body under so much stress that's what will result. There can be a link between iron deficiency and amenorrhoea where the body stops ovulating to 'preserve' current iron levels.

I have been told to run less and put on some weight if i want my fertility chances to increase. after running the gold coast half marathon i will slow down the training intensity and concentrate on my health.

sorry probably not much help but hopefully a ton of empathy!

[TashyTuffNut]

Julz83, I really appreciate the empathy! It's nice to know I'm not alone with this problem.

Thanks everyone for your comments.

I have a feeling that I might not be absorbing the iron at all as for one, I haven't gotten any of the "awful" side effects everyone talks of regarding iron supplements. So a gastro enterologist might be a good option.

In the meantime, I made an appointment to see a specialists sports nutritionist who deals with ultra marathoners and vegetarians. Amazingly I got an appointment with her tomorrow so am hoping she will help me sort this out.

Thank you all again!

[twosheds]

Hi Tash, there is something called pernicious anaemia  that is related to the absorbtion of iron and it is related to vitamin b 12 ( I think it is ). I dont know much more about it and have no first hand experience. Might be worth looking into.

[UnfitnessFanatic]

HI Tashy, My wife also struggled with her iron levels which got worse and worse and nothing she did seemed to make a difference.  Turns out she has ceoliac disease which wasn't allowing the iron to be absorbed.  Maybe another avenue to look down?

[TashyTuffNut]

Thanks everyone for your replies. I really appreciate your thoughts.

I went to the sports dietician on Saturday and she reckons it's fructose malabsorption. It makes so much sense. I have gotten so used to feeling nauseated and having an upset stomach that I've learned to treat it as normal. But it's been affecting my bodies abilitiy to absorb nutrients.

So following the fodmaps diet for the next month - which by the way, sucks pretty bad if you're a vegetarian - and will see if levels and symptoms improve. It's crazy that I was eating so many "healthy" foods thinking they would help my iron and overall nutrient levels but instead my body was rejecting them. I guess it's a lesson learned to stop self diagnosing all the time and seek a professional opinion

[ChloeP]

Have you tired upping your intake of iron through food? Kangaroo meat is a great source of iron. Another thing you could do is eating a few handfuls of peanuts throughout the day...

ChloeP

[rohan]

Quote

Can't seem to fix my iron levels - help!

Until you've gone the injection route you haven't really tried yet.

1. Diet is the long slow way so forget it as a short term bump up which you need.  

2. Iron tablets vary HUGELY in the amount they contain.  Check what yours actually contain and what others contain. Get the industrial strength ones.

3. Absorption is aided by taking in the presence of Vit C and away from Calcium, as others have said. Check for the ideal things to consume the iron in the presence of.

4. Injections. Fast. Effective.

 ChloeP, on 26 July 2012 - 11:34 AM, said:

Have you tired upping your intake of iron through food? Kangaroo meat is a great source of iron.

... not generally regarded as vegetarian food.  Unless you're one of those 'vegetarians' who eat chicken... and pork... and fish... and basically all meats except cow.

[TashyTuffNut]

 rohan, on 26 July 2012 - 01:41 PM, said:

Quote

Can't seem to fix my iron levels - help!

Until you've gone the injection route you haven't really tried yet.

1. Diet is the long slow way so forget it as a short term bump up which you need.  

2. Iron tablets vary HUGELY in the amount they contain.  Check what yours actually contain and what others contain. Get the industrial strength ones.

3. Absorption is aided by taking in the presence of Vit C and away from Calcium, as others have said. Check for the ideal things to consume the iron in the presence of.

4. Injections. Fast. Effective.

 ChloeP, on 26 July 2012 - 11:34 AM, said:

Have you tired upping your intake of iron through food? Kangaroo meat is a great source of iron.

... not generally regarded as vegetarian food.  Unless you're one of those 'vegetarians' who eat chicken... and pork... and fish... and basically all meats except cow.

Do you get the injection from a GP?

Since following the low fodmap diet, I feel heaps better and am sure that I'm absorbing the nutrients better from my food but I need that quick fix just to get things back to normal. The injection sounds good.

After seeing the dietician I made the discovery regarding the differences in iron levels in different supplements. After taking Swiss and Blackmores, which did nothing, I'm now on the Ferro-Grad C which I've been told by the GP, Dietician and Pharmacist are the best ones.

Haha, and yep - I'm not one of those types of "vegetarians" so roo is not an option

[adventurelete]

Eating Vitamin C rich food inconjunction with Iron rich foods boosts the bodys absorption of iron.

Conversely drinking tea and coffee inhibits the body's absorption of Iron.

So firstly I would cut back on the coffee/tea and eat more foods high in Vitamin C just before or with your iron rich fods.

Also how many Calories are you consuming each day? and do you track this on a regular basis?

More calories (from clean, healthy, low fat foods) will help you consume more iron in general (along with the other vitamins/minerals you need)

[wharfie]

hmmm. My missus has low iron levels. She had an iron infusion via iv. It certainly improved her iron levels. She did however have a bad reaction to it the next day and ended up in hospital for the day. Interestingly I asked my doctor about my iron levels and he said that because I was a heavy drinker that my irons levels would be fine. So maybe try a glass of wine a day???

[TashyTuffNut]

 wharfie, on 03 August 2012 - 10:25 PM, said:

hmmm. My missus has low iron levels. She had an iron infusion via iv. It certainly improved her iron levels. She did however have a bad reaction to it the next day and ended up in hospital for the day. Interestingly I asked my doctor about my iron levels and he said that because I was a heavy drinker that my irons levels would be fine. So maybe try a glass of wine a day???

Haha! I like that suggestion

Am already doing most of the things suggested - don't drink much coffee or tea and never with meals. Eat lots of vitamin C rich foods etc.

I feel like I'm absorbing the nutrients from my food a lot better since being diagnosed with FM and following the low fodmap diet. But I still feel I need a pick me up just to get to a "normal" level. So next time I'm at the GP will ask about the injections.

Thanks for all your suggestions and advice!

[Kibbs]

Maybe work on better absorption of what you are already taking? Consider more Vit C etc.