Tuesday, 29 March 2011

Haemoglobin is our Friend

As I sit here with a slightly sore bum, I feel I owe it to those whom I have been cranky with over the past months, to explain my behaviour, and to warn all the runners out there of the perils of low iron levels.

The reason for my tender gluteus is that I’ve just received the third of a course of 10 iron injections. After some shocking race results, including my worst ever finish at the Northern Cross Country Championships in January, I had a feeling something wasn’t quite right.   Apart from slightly heavy breathing every time I ran up a hill, and a general lack of progression in training, there was nothing at that stage to suggest that I was ill. Oh there was the extreme coldness all the time, but I had just put that down to loosing weight and not being acclimatised to sub-zero temperatures. Things got worse from there on though, and slowly, one-by-one, most of the common symptoms of anaemia started to rear their ugly heads – general malice (ok, so I’m not sure what exactly malice means, but it’s one of those words you see in the medical text books relating to just about every medical condition known to man), slow recovery from training, muscle soreness and heaviness, mild chest pains, paleness, viral-like symptoms, severe headaches, crying, a mildly depressed mood, crankiness, oh and some more crying. The one symptom that I didn’t really experience was tiredness.

A blood test revealed a haemoglobin level of 10.0, and a haemotcrit level of 30%. Add to that serum ferritin levels of just 7, and it’s a wonder that I could run at all. Altitude training is supposed to increase red blood cells, but after spending 5 of the past 11 months at altitude, I’m in a worse position that I was to begin with. Not only have I wasted all that training, but the pale complexion is ruining the tan that I worked so hard to get!!!

Almost 6 years ago my progression as an athlete was completely ruined by the same problem. I went from the shape of my life, to the shape of a Joe-jogger in the space of 12 months. Now, just as I was finally getting fit again, the cycle repeats itself. I knew I had to be careful, and I knew what to look out for, and so, I have to ask myself what went so badly wrong.

I had been getting my haemoglobin levels checked every time I was ‘back-in-town’, but these failed to highlight that my ferritin levels were dangerously low. I suspect that two weeks in Ethiopia, on a diet practically devoid of any animal products, may have been the cause of the decreased iron stores. Almost 1 month, equivalent to the life-cycle of a red blood cell, after returning from Ethiopia, things started to go pear-shaped. If I had gotten a full blood screen at that point, I may have avoided the situation.

Now that things are starting to return to normal, I realise just how much my low iron levels were affecting me. I was experiencing severe muscle soreness for 4 to 5 days after each weights session that I did; now I’m back to the more normal 2 days of soreness. I don’t feel so cold all the time. And when I look in the mirror, I’m starting to see myself looking back, not some ghost-like caricature of myself.

Six years ago, my anaemia was accompanied by burnout, and because of the symptoms I was experiencing I was convinced that I had a virus which three separate doctors couldn’t diagnose. I took a month off training completely, wallowed in my own self pity, and never returned to the shape I had been in the previous year. This time round I’m far more in control of the situation. I’m running most days. While that was just 15 to 20 minutes to begin with, now I’m managing an enjoyable 40 minutes regularly. Sometimes I don’t even wear a watch, and am learning (after 16 years) to ‘run how I feel’. While I know I can’t push things, I’m determined to maintain as much fitness as I can, and, unlike before, am motivated to return to my very best.

Normal red blood cell levels are vital, not just for endurance, but for life in general. Be sure that you get your levels checked at least twice per year, and have them even more closely monitored if you are training at altitude. Beware of the symptoms, but don’t expect them to be the same in all cases. Don’t necessarily expect to feel tired.

If you want to find out more, a factsheet on iron, haemoglobin and red blood cells will be uploaded onto the website in the next few days.

If haemoglobin is our friend, mine has deserted me.  But, hopefully, not for long.

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