Knowledge is Power

I don’t post here every day but I share my running, training and life happenings on Instagram daily!

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They say knowledge is power. And it’s incredibly true in this case. I am grateful that I finally know what has been causing me to feel so incredibly awful the last 4-5 weeks.

Four weeks where every single run felt like a struggle. Where an 8:00 pace felt like sub-7. Where my legs were as wobbly and tired after 2 miles as they used to feel after 22 miles.

I love the feeling of being tired on a run – when it’s expected. Those day-after-hard workouts runs where everything hurts and you are running slow. But, this was different. It was week after week of feeling wiped out and not having any answers or explanations why.

It’s been a hard few weeks for me. Both physically and mentally. More than anything, I missed the feeling of enjoying a run. I felt drained. And running felt more like a chore. So I stopped. I’ve run enough to know when my body is sending signals to slow down. I ran 27 miles two weeks ago. The week before was 29. Took more rest days than run days.

BUT, the good news is that I feel like I’ve turned the corner and am finally, FINALLY feeling better. I received my test results from InsideTracker last Friday and it provided answers and a way ahead. And I’m hopeful that after a few more weeks, I will feel even better. If you are interested in trying InsideTracker, you can use code “NYCRUNNINGMAMA” for an awesome discount (this is not an affiliate link).insidetrackerI’ve spoken to several knowledgeable people after receiving my results – from my friends Tina, Jess, Laura and Mary to my coach, to my wellness coach, to Jonathan from InsideTracker. And most have been in agreement that I should focus on the ones that are lowest and most at risk: Vitamin D and ferritin

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ferritin

As Coach Hadley put it, it’s a double whammy for me. Both low ferritin and low Vitamin D cause a number of the same symptoms.

Vitamin D deficiency:

That can make you feel sluggish, chronically sick and slightly depressed. It can even make you run slower. without enough Vitamin D, your bones are more likely to fracture. This is not good for runners who want to stay uninjured. People who have Vitamin D deficiencies tend to complain about general muscle soreness. Competitor Running

Low Ferritin Levels:

For the average person, normal ferritin levels are quantified as 12-300 nanograms per milliter (ng/ml) for men and 12-150 ng/ml for women. To put it bluntly, an athlete running with a 12 ng/ml ferritin level will be feeling the effects of anemia and their training will be suffering. Runners need to be much higher on that scale. – Competitor Running

After reading and learning about all of this, I view Boston in a different light. I’m still sad with how the experience went down because I know I was in shape to have a breakthrough marathon. BUT I’m amazed and thankful that my body got me to the finish line despite all of this going on. It puts my mind at ease that it wasn’t stress from the race or my mind playing tricks on me with how I felt. And, I wasn’t overtrained. I think this makes me happiest. I feel like the first response I got from some people were to ask me if I was overtrained – almost as if they were waiting for that to happen to me. I pride myself on taking cues from my body and there were several times during the cycle that I backed off mileage or intensity because my body didn’t feel up to it. I couldn’t wrap my head around being overtrained – and these numbers just show that.

I’ll be totally honest. I know what Vitamin D is, but had no idea that these were the symptoms. And I have only recently learned of ferritin. So this was a lot of new information for me.

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Vitamin D

One of the most common ways of getting Vitamin D is through sunlight. This was the first winter where I was in the sun virtually never. I’d get up and run in total darkness and be on the bus as the sun was coming up – and then spend the entire day in my office (I typically bring lunch and when I don’t, I head to the cafeteria). When I would leave at 5:30pm, it was already dark. This routine happened from October through now.

But from what I’ve read, most people do not get enough sunlight during the winter months, even if you do spend time outside each day. So it’s something to be aware of. If you aren’t deficient, a multivitamin might be enough to give you the amount your body needs.

Based on the test from InsideTracker, my Vitamin D level is 27 which puts me just under the “not optimized” zone and in the “at risk”. InsideTracker recommended 5,000IU per day and eating fatty fish at least twice/week.

I’ve begun taking two servings of a Vitamin D3 supplement – so 4,000IU from that supplement and a multivitamin which gives me another 800IU.

My husband and I have also made a pact to eat more halibut, sockeye salmon and eggs on a regular basis (although I already eat eggs at least 3-4x/week).

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Ferritin

I assumed since I was eating red meat on a regular basis that all my irons levels were sufficient. While my iron levels are considered optimized, my ferritin levels are very low.

If you are like me, than you may not be familiar with ferritin levels. Ferritin is the amount of iron stores in your body.

The best way to imagine it is to think of your iron as your checking account and your ferritin as your savings account. You want your checking account to have enough money so that you have cash for your daily needs. But, you also want to ensure that you’re making deposits into your savings account on a regular basis. You want your savings account to have plenty of money – so that money is there on the days where you need a little more money in your checking account for bigger purchases.

Your Iron and Ferritin are two different measures of iron in your body (note: there are other measures as well). Just because one is optimized does not mean that the other is as well.

Runners, and especially female runners, are at risk to have low ferritin because we lose more iron on a regular basis:

Through your feet – First, a process called foot strike hemolysis occurs in runners, especially those who run high mileage. Foot strike hemolysis is a process where red blood cells are damaged when the foot hits the ground, thus reducing your hemoglobin levels.
Through sweat – Iron is lost through sweating. While the amount of iron loss isn’t staggering, for a runner working out in hot and humid conditions, the losses can easily add up.
Through the intestines – Loss of iron through the GI tract (primarily the stomach or large intestine) is a problem for some athletes. Iron loss through the GI tract is fairly minor, but there may be a cumulative effect over months of running that leads to iron deficiency.
Female runners – Finally, female runners have an especially difficult time maintaining proper iron levels since they also lose iron during menstruation. – Runner’s Connect

Based on the test through InsideTracker, my ferritin is 14 – which is considered super, super low.

The main symptom of low iron levels is fatigue and a slight shortness of breath.

You will be dragging most of the time. All of us have those bad days but this is a continual worn out feeling. Your performances slide. Your pulse rate may be elevated and your enthusiasm for running is just not present. Running.net

So what changes have I made to increase my ferritin? I’ve been supplementing with a chewable Iron for a couple of weeks. I was taking it once/day but have been aiming to take at least two/day for about 5 or 6 days now. This is the third type of iron supplement I’ve tried in a couple of weeks and I still haven’t found one that doesn’t upset my stomach. From what I’ve read, it’s not unusual for some people to have these symptoms when they start taking an iron supplement. I’m hoping that once I get my levels up (maybe a couple of months), I can pull back on the frequency of the pills.

InsideTracker provided a list of about 10 foods to incorporate into my diet to increase my ferritin levels. I already eat dark chocolate and red meat on a regular basis. Some of the other types of foods listed (peanut butter, beans), I don’t eat. Which leaves spinach and artichokes. I am not crazy about either of these but will eat them – so my husband and I are making more of an effort to incorporate them more frequently into our diets.

The interesting part is that I eat red meat about 5-6x/week. We eat a lot of steaks for dinner (we purchased a 1/2 grass-fed organic cow with my sister and her family and our freezer is packed with the meat) and I often eat the leftovers for lunch the following day. And it’s a weird predicament b/c my cholesterol levels are not optimized (HDL and LDL) and one of recommendations for that section is to adopt a vegetarian diet.

With my low ferritin is also low hemoglobin and low TS (transferrin saturation). Both of these are part of the Iron group and affect running:

Symptoms of low hemoglobin can include paleness, weakness, fatigue, palpitations, issues with regulating body temperature, low energy and skin numbness or tingling.

Low transferrin saturation can indicate that your overall iron is low, which can make you feel lethargic and weak, have a weaker immune system, and reduce your mental function.

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So those are the two areas that I’m really focusing on right now. As I mentioned last week, there are 9 areas that are either at risk or not optimized. But rather than start making a ton of changes to improve all the biomarkers, my goal in the short-term is to focus on the two impacting my running the most. I want to get my Vitamin D and Ferritin up a bit (and I’m hopeful that the Hemoglobin and TS will increase as well)…and then I will start looking at the other areas.

I also have backed way off the intensity of running. I made the decision to DNS this weekend at the Newport 10k. As much as I wanted to race, I know myself and knew that if I went to the race, I would want to race it – regardless of how much I told myself to take it easy. I started to feel better by the end of the week but knew that a too-hard effort could push me back into the red and I’d have to work just as hard to get back to where I was. So nothing hard, nothing fast. I kept all the runs last week between 4-6 miles. Saturday was the longest since Boston (11 miles) but I kept it relaxed and steady.

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I also decided to skip the race on Saturday because I am not someone who runs races just to run them. I don’t do races just to post photos on Instagram or get a medal. If I’m going to a race, I’m either helping a friend run or I’m racing it. I outright refuse to miss out on time with my children, especially now that I am away from them for 12-14 hours/day during the week. Saturday’s race was 45 minutes away. I would have had to give up 3+ hours with my kids – and most importantly, miss their soccer (they play two days/week but I don’t make it home in time on Wednesdays to watch them) – to run easy for 6.2 miles. Something that I could do while they are sleeping and just walk out my front door. So for that, it wasn’t even a choice for me.

So I ran 11 comfortable miles, went to soccer with my husband and sons, spent some time at an amusement park and then spent the afternoon celebrating my godson’s birthday! My idea of a perfect day!

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If you are interested in trying InsideTracker, you can use code “NYCRUNNINGMAMA” for an awesome discount (this is not an affiliate link).

InsideTracker has added a new panel – the High Performance Panel – which includes a ton of the biomarkers I was tested for. You can find out more here.

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    19 thoughts on “Knowledge is Power

    1. Great post! I’m definitely going to give Inside Tracker a try. I’m a CrossFitter, but your running experience has been helpful in making my decision to get the testing done. Thanks!

    2. I am happy you are feeling better. Knowledge is power I appreciate that with you. Fitness Both physically and mentally are main factors for Runs. You are lucky you have lots knowledgeable friends Tina, Jess, Laura and Mary. Hope doing everything Okay.
      Mile22 recently posted..Disney Races for Marathon RunnersMy Profile

    3. I spent about two years in severe anemia (and thus had the symptoms you described) and nobody said anything because my hemoglobin was fine – AND they don’t check it on routine blood tests, so even your doctor won’t tell you that you’re anemic unless you specifically request the information. Kaiser listed the reference range as 22-291 and said my results were <5 and didn't even give a specific number! It's terrifying. It's really lucky when you can finally figure it out – especially when fitness is your thing! I also have major stomach issues when it comes to taking supplements, and eating food in general (my doctor told me to take three supplements per day! ha), but I have found that I am able to handle taking ferrous sulfate tablets about three times a week. I would recommend trying those! I was told it was a better option than the more common iron supplements when you're having ferritin-specific anemia rather than hemoglobin. Don't ask me the science, though. Also – homemade spinach-artichoke dip! Just sayin'. 😉
      mclicious recently posted..i mudded! again!My Profile

    4. Hi, you really need to think about the amount of sleep you get. Why aren’t you absorbing all the iron from the red meat you are eating? I know you said you are happy that it wasn’t a fact of being over trained, however maybe you should consider that cutting back on the sleep is not allowing you to recover properly and that is building up over time. They did a study on mice where they kept them sleep deprived until death ( I know, horrible) but they didn’t end up dying of exhaustion or heat failure. Every single one died of infection. Lack of sleep may be the reason you are at risk in 9 areas. This is not to be taken lightly.

    5. Hi There –

      I love spinach….my boyfriend? Not a big fan. So I put it into different dishes and he can see that’s it’s there, but it’s not a green pile of mush on his plate…and that tends to help.

      One way I like to serve it is with meatballs and sauce. I use about 1.5oz of spinach per lb of beef. Then add all the other things your like (I use 1 egg, 1/3 cup panko breadcrumbs, 1ts salt, 2.5 cloves of garlic mix w/ 1lb of beef). I make my meatballs, toss them in a pan to brown. Then add the sauce and simmer for 7-10 min’s until the meatballs are done (I make 1″ meatballs so they cook quick). Off heat and mix in another 1.5oz of chopped spinach and 1/4 cup of chopped basil. S&P to taste.

      I also add baby spinach (usually milder in flavor) in our smoothies in the morning. When I have pineapple of berries mixed in, he has no idea it’s there.

      So think about recipes you like and just add some spinach. You might be surprised! Good luck to you and thanks for sharing. Interesting stuff!

      -steph

    6. I’ve struggled with iron, too. Formerly a veggie, I eat beef but I still take a lot of care with my ferritin levels.
      One piece to the iron puzzle is coffee and tea inhibit iron absorption, so don’t take iron when you drink coffee or tea. I usually take my iron at night.

    7. Thanks for sharing, I struggle with this as well. I’ve had chronically low Vit D for years. Apparently a huge majority of the population has low Vit D and doesn’t know it. I also just found out my ferritin at 14, so you’re in good company :)

      I took a supplement called Clinical Iron which I feel like worked, but I think it messed with my already messed up digestion. You might want to give Mega Food Blood Builder a try. Also recommend putting spinach in your protein shakes, you won’t taste it there.

      My primary care doctors check for this stuff every year at my yearly physical, you can start there if you need to get levels checked.
      michele recently posted..Wrentham Duathlon 2016 Race ReportMy Profile

    8. Soooo glad you have some answers and can work on getting your Vitamin D and Ferritin up. You’ll feel so much better when you do especially since you had a pretty good race considering you felt so bad (just wait until you feel better bc you will feel like you are flying when you start training again).

      I’ve had low iron and low ferritin before, and I get mine monitored/checked often (2x a year). It was amazing when my ferritin went up… running no longer sucked! I actually had a “kick” at the end of races and I recovered better between runs and workouts. I could get up in the morning at 5 and lift, then run that afternoon, without having to take naps every day.

      I became anemic when marathon training one summer. I thought I was over it, but the increased time on my feet with the training, coupled with the summer heat and humidity (losing iron through sweat) caused my ferritin and hemoglobin to drop.

    9. This is a really interesting post! Apparently I was InsideTracker’s 5000th Instagram follower and as a result, they are sending me a surprise in the mail! As a result, I’ve been doing more research on what they do and what kind of information I could learn!

    10. I can tell you the struggle is real with a low vitamin D and ferritin.
      I spent a year depleted with both when my Crohns was flaring. My GI tract was basically just constantly bleeding which means I absorbed no nutrients.
      My ferritin level was between 1-3 until I went into remission and they marveled how I continued training but I am stubborn even when so sick. When you put your mind to it, like you did with finishing Boston, you finish.
      Now after many iron infusions and remission I am well within normal and I feel like a new person! So hopefully you will get it leveled out as well! Knowing is so helpful!
      Gianna @ Run, Lift, Repeat recently posted..Running Recovery WeeksMy Profile

    11. FYI: fish, shellfish, and seaweed are also good sources of iron, but without the cholesterol.

    12. Re: iron, Elixir Liquid Iron is the only one that works for me. I take it 4x week, mixing 1 1/2 tbsp with OJ (vitamin C helps iron absorption). Everything else gives me the worst stomach cramps… I cannot even take multivitamins containing iron because they make me so sick!

    13. Also, regarding Vitamin D, during the winter months when the sun is at a lower angle, most, if not all (depending on how far north you live) of the UVB rays that provide vitamin D are filtered out through the earth’s atmosphere, so it’s even more important to take supplements. It’s also important to give them to your kids! In Canada, my Dr recommended that I start supplementing them as newborns. I got lax this past winter on my Vitamin D and my energy, immune system and training suffered.

      I hope that you’re feeling better soon!

    14. A simple change that helped my iron levels was to start using a cast iron skillet almost exclusively, especially when cooking acidic foods like tomatoes. A tiny bit of the iron leaches out.

      It might be worth going to your regular GP and getting a full iron panel — TIBC, serum iron, transferrin levels, transferrin saturation, etc…

      The iron form, I had the best luck with was ferrous gluconate — it did not irritate my stomach like the other forms of iron

    15. I actually talked to Jonathan yesterday and purchased the performance test. I’ve been feeling “off” lately and I start training for my first marathon in about a month so I am looking forward to seeing what I need to work on in order to be a stronger, and healthier, runner.