Instead of contributing a typical athlete blog entry entry, Classical High School senior Maddy Berkson from Rhode Island wanted to shares with MileSplit her struggles and how she overcame being iron deficient last year as she is now one of the nation's top ranked runners from 600 meters to 3000 meters this indoor season. Read her piece below as well as the good information that she provides for other runners who may be anemic or experiencing low ferratin levels which are affecting their race performances.
By Maddy Berkson
A month after finishing third in the 800 at New Balance Indoor Nationals, I wasn’t able to complete easy workouts.
A few weeks after the 2013 indoor season ended, I expected to have a good 3K race at the New York Relays. Instead I finished 20 seconds slower than an early season indoor time and my legs felt unusually tight and tired. It was surprising and frustrating.
In practices, I could no longer hit any target times – my legs kept tightening up and my breathing became labored quickly. It took all my effort to just finish reps over 400m, never mind hitting any sort of time. In my running log, I chalked it up to inadequate sleep and not enough stretching (both of which were probably true).
My Penn Relays mile experience was similar to the New York Relays 3K. I was in the race for the first 800m, but fell off after that and could only hang on and try to finish. I was wiped out after, and felt similar to how the 600m reps had felt in the workout a few days prior – very tight legs, difficult breathing.
Frustration dominated this period of decreased performance. Whenever I couldn’t hit workout times or had a bad race I obsessed over what I could be doing wrong. Maybe my running career had peaked and it was all down hill!
When I first started feeling tired during workouts, coaches and friends suggested that I get my blood checked for low iron or any other problems. I read some articles online which indicated that iron and ferritin deficiencies come on gradually, over the course of weeks or months, and that the associated fatigue would permeate all aspects of life. I read some articles about runners who found it hard to stay awake during class, due to an iron deficiency. But, I felt fine during the day, and my easy runs felt good. I only had symptoms during workouts and races. I went to see my doctor and she ordered many blood tests. The results showed that everything including iron was normal although my ferritin level was a little low. In order to raise the ferritin level the doctor suggested I take a daily iron supplement pill (ferrous sulfate containing 45 mg of elemental iron).
Since things were not getting much better after about two weeks, we asked to see the blood test results. My hemoglobin level was within the normal range shown on the report and my ferritin level was 7 ng/ml, which was slightly below the normal range. After doing some more research, my parents and I found that 7 is very low for runners and was likely the cause of the drop in performance. The reference interval for an average person is 10-120 ng/ml, but for runners it should be much higher. For female runners some think, “levels under 25 ng/ml will cause significant drops in performance.” (http://www.runningwritings.com/2011/11/ferritin-hemoglobin-and-iron-deficiency.html)
With the RI state meet, New Englands, and Nationals coming up I started aggressively increasing my iron intake. I took at least 100 mg of elemental iron in ferrous sulfate per day with a multivitamin (Vitamin C aids iron absorption), reduced the amount of milk I drank (Calcium inhibits iron absorption), and ate calf’s liver a few times a week (liver is very high in iron, unfortunately). The turn-around time was a lot quicker than I expected. After reading about ferritin and iron deficiencies I was under the impression that depletion of iron and ferritin happens over a long period of time, and getting back up to acceptable blood levels occurs at an equally glacial pace. However, my workouts improved dramatically within about two weeks of the new supplement routine. At the RI State Meet I felt back to normal, and I had three good races. I had my ferritin checked a few days after the meet and it was up to 18 ng/ml. Still low, but a big improvement from 7.
More recently, right after the 2013 cross-country season, I experienced a similar decline in workouts. I had reduced the amount of iron I was taking during the season, since it bothered my stomach, but maintained the number of miles and workouts I did. In early December, I couldn’t complete workouts that should have been easy, and felt the familiar leg-tightness, heavy breathing, and frustration that I felt last spring. My December blood test showed 16 ng/ml of ferritin, down from 20 in late October, which was down from 29 in mid-August. I immediately started taking more iron again. Now my ferritin level is 30 ng/ml and workouts have been going great.
You may think that iron supplements are like magical pills that make you run faster and feel better. They are! I felt remarkable differences in training and racing that seemed to be directly correlated to how much iron I was taking. There is one drawback; iron pills have not been kind to my stomach. From a few weeks after I started aggressively taking iron pills in May until now, I have had chronic stomach problems. At one point it was so bad that I had a hard time sleeping. Near the end of the summer, my stomach got especially bad. Since training was less intense at that time and my ferritin level was relatively high, I cut back on the iron to see if that decreased stomach discomfort. It didn’t. In September and October I experimented with different things to try to help my stomach. Nothing helped so I just lessened my iron intake to 40-80 mg of iron per day. In late October my stomach was not much better and my ferritin level was slipping. In late December I switched from ferrous sulfate pills to ferrous gluconate pills. So far, my stomach has been fairing much better with the ferrous gluconate pills. I now take 108 – 135 mg of elemental iron in ferrous gluconate per day, accompanied by Vitamin C and folic acid supplements. I eat meat often, and liver a few times a month (It is important to mask the liver flavor as much as possible! I eat it with fried onions and bacon. Luckily, bacon is another good source of iron and my dad is a good cook.
A plateful of iron!
On January 21st my ferritin level was 30.
If you are experiencing an unexplained drop in running performance, you should probably go to your doctor’s office and ask for blood tests. Suggest that they test for ferritin, since it might not be in their standard arsenal of tests.
Currently, rigorous controlled studies with large numbers of subjects linking ferritin and running performance have not been performed. But I am convinced by many anecdotes, small studies and my own experience that low ferritin is a possible explanation for an otherwise inexplicable decline in performance.
References:
http://www.coachesdirectory.com/new/coachesinsider/track-read.php?page=content/tf-iron.html
http://www.cmaj.ca/content/184/11/1247
http://ajl.sagepub.com/content/6/4/319
http://www.ncbi.nlm.nih.gov/pubmed/23436684
Instead of contributing a typical athlete blog entry entry, Classical High School senior Maddy Berkson from Rhode Island wanted to shares with MileSplit her struggles and how she overcame being iron deficient last year as she is now one of the nation's top ranked runners from 600 meters to 3000 meters this indoor season. Read her piece below as well as the good information that she provides for other runners who may be anemic or experiencing low ferratin levels which are affecting their race performances.
By Maddy Berkson