Iron running

This week, I want to touch on an interesting challenge faced by distance runners.

I was recently speaking with a friend of mine who is an avid runner and athlete. When he started to notice his running times drop and fatigue setting in quicker then normal, it became clear there was something going on with his health. This led to a doctor visit. After both upper and lower GI scans, it was determined he had celiac disease. Celiac disease can lead to poor absorption of essential minerals like iron and calcium.

Here is where it gets interesting; his performance dropped due to anemia or low iron levels. This could have just been related to the celiac disease, but distance runners among others can also develop a condition known as pseudoanemia.

This occurs when there is an increase in plasma volume, which is the liquid part of the blood, as a result of regular training. This then leads to low serum ferritin or iron levels.

With his celiac disease adding to his anemia and his distance running adversely affecting his iron which is stored as ferritin in the liver, spleen and bone marrow, my friend's anemia was becoming a severely debilitating issue which could have led to much more serious health issues.

Most competitive or elite athletes know they can become sensitive to the effects of iron deficiency due to the stress they put on their body's ability to transport oxygen to their muscles. But for the most part, with other active people and part-time athletes, it is not commonly known that certain types of exercise and regular training can cause iron loss and lead to anima. This point, when factored in with other health issues like celiac disease, makes it very important to pay very close attention to iron intake or solid nutritional choices to properly nourish the body.

Let's focus on iron for a moment. When you are physically active and/or training your body, it increases its demand for iron, so red blood cells or hemoglobin and muscle cell myoblogin can carry the increased oxygen required for the increased level of exertion. Within this process, it is important to understand that in order for the hemoglobin and muscle cell mycology to carry the oxygen, it needs an adequate amount of iron to function properly.

When you regularly train or are very active, a shortage of hemoglobin due to iron deficiency will drop your performance and decrease energy levels. Low iron will lead quickly to muscle fatigue and cramping. Athletes who have an extensive training schedule like long-distance running or swimming, for example, have a much higher risk of inadequate iron intake than other active folks. There are other people who should pay attention to their iron intake such as vegans or vegetarian athletes, due to the low absorption of iron from their diets. There are a few studies that show iron absorption in athletes tends to be lower than in non-athletes. One theory why this is the case is that food tends to pass faster through the digestive tracts of highly active athletes.

One more notable piece of information specific to distance runners is a condition known as foot strike hemolysis. Although this is specific to running, there are studies which show similar issues occurring in swimmers and other athletes. Foot strike hemolysis occurs when red blood cells are damaged when the foot hits the ground during prolonged or frequent running, reducing hemoglobin levels which can lead to anemia.

So what is the likelihood you will develop anemia if you are an avid and frequent runner or competitive endurance athlete? The overall statistic of men in the U.S. who have bouts of anemia is between .02 and .06 percent and women are slightly higher. There is not a statistical increase of anemia in athletes outside the general population, but with athletes, mild anemia can go unnoticed and even at low levels will affect your ability and performance, so getting enough iron through good nutrition is critical.

While anemia may not be a common issue for most active people or athletes, it can be a risk factor leading to fatigue, reduced performance and chronic cramping. If you are an endurance athlete with an aggressive training schedule, be sure to have your iron levels checked when you have a physical exam, or consider having it checked anytime you experience persistent fatigue with no obvious cause.

The other point you must keep in mind is regarding iron supplementation. Too much iron supplementation can lead to even bigger health problems, so always check with your doctor before taking iron supplements. If you do find you have anemia, it is always best treated by your doctor since proper iron intake and supplementation can vary so much between age group and gender.

Judd Jones is a director for the Hagadone Corporation.