The Answer: Iron Depletion!

For those of you who don't know, I've struggled with maintaining an adequate iron level for my entire running career.  In fact, I first found out about the effects of low iron on running during my sophomore year of high school, where I struggled to run faster than 6:30 pace in races.  I couldn't breathe when going up hills and I was gasping for oxygen if the pace ever got fast.  The first doctor I saw diagnosed me with exercise induced asthma.  After the inhaler didn't work, we saw another medical professional who found out that I had a ferritin level of 3, which almost required hospitalization for an iron infusion. 

If you don't anything about iron, I'll give you a quick lesson.  Iron has two essential components:  hemoglobin and ferritin.  Hemoglobin carries oxygen to your blood.  Ferritin helps the body store and transport iron.  Without iron, it feels like all the energy has been zapped from your body. Taken from one source: "In athletes, Iron Deficiency Anemia can lead to dramatic and measurable decrease in athletic performance, work capacity, reduced VO2max—and this effect is reversed when iron supplements are taken."   

I struggle with maintaining a reasonable ferritin level.  Some people may say it's because I'm a vegetarian, but I don't believe that eating meat will magically increase my iron levels.  After all, I was able to get my iron level to a 53 in March of this year, which is the best level I've ever had.  I clearly didn't start eating meat for the first time in 25 years during that time.  Instead, I started eating more leafy greens and beans. 
 
I have such a history with iron depletion that I have maintained an excel spreadsheet to track my levels since 2004 (see picture below).  The general ferritin level that female athletes strive for is above 20, and this is still on the lower end of the spectrum.  The average ferritin level I've had since 2004 is just 17.95.  My current level is a 5.  For me, I feel like magic if I'm above 15.  I also know that whenever I get below 10, I will experience the fatigue that is associated with iron depletion.  The results of low ferritin levels for runners are significant and I've experienced them too often for my own taste.  Symptoms?  Abnormal exhaustion, increased blood lactate, slow recovery, declining performances, heavy legs, muscular tightness, loss of motivation, and substantially increased risk of injury.
 
The good news is that all I have to do is increase my iron supplement (fortunately I have a tough stomach and can take a lot) and focus on eating all the iron-rich vegetarian foods that I already know about: kale, lentils, black beans, dried apricots.  After that, the iron level should jump up within 2-3 weeks.  The key is to understand that I will probably need to adjust my target paces for most of my workouts.  The best part is that the effort will still be there and should carryover once I start feeling better.  When that happens, I should feel like I just got back to sea level from running at altitude!  I also know that if I gradually ease into the pace, I usually can maintain a speedy clip. 
 
Cheers to understanding iron depletion and for not being injured!