September 2004

Previous issues

Each month we offer a new article by Kitty Consolo, Ph.D.   Kitty is a veteran runner and exercise physiologist.  She has been running and racing since 1975, and has won over 400 road races ranging from the mile to the marathon and went to the first women's Olympic marathon trails in 1984. Kitty has a PR of 2:42.46 for the marathon and 35:02 for the 10km,  She now enjoys shorter races and masters running. 

Dr. Consolo is currently an assistant professor at Ohio University Zanesville where she teaches a variety of health, PE classes as well as human anatomy and physiology.

Enjoy, and please let us know your thoughts about the Runner's Corner!

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Iron Deficiency in Runners

 September 2004 Runner’s Corner by Kitty A.  Consolo 

Those Most at Risk

        A common over-looked cause of fatigue in running, particularly in the summer months can be iron deficiency.  Iron is lost through our sweat and in women, through their monthly periods.  Iron deficiency can also result if your diet is poor in iron-containing foods such as red meat, raisins and spinach.  Some cross country teams have found as many as 25% of their female runners and 10% of their males runners to have low iron.  However before you rush out and start taking an iron supplement, it is important to get a blood test first. 

Serum Ferritin Blood Test

        If you have been feeling very tired training, especially going up hills and walking up stairs and you are also a heavy sweater, and/or do not eat a lot of red meat, you may be deficient in iron.  However, too much iron can be toxic to the body so it is important to get an accurate test to determine if your iron stores are really in jeopardy.  Make an appointment with your doctor and ask to have a blood test that measures your serum ferritin and your hemoglobin.   It is important to have both as serum ferritin indicates iron storage which can begin to get low long before you become truly iron deficient which is called anemia.  While hemoglobin levels can tell you if you have anemia, often a low serum ferritin level will result in poor performance and fatigue long before one ever gets to anemia.  The sooner you are diagnosed, the better.  Try to keep your serum ferritin levels about 60 though some doctors do not become concerned unless it drops below 20.   Keep a journal and note at what level you need before you notice performance drops.  I keep mine at 80 or above and many of the world class athletes, both male and female, keep their level up there as well.   In regard to hemoglobin levels, men usually have a slightly higher level than women, around 14 versus 12 due to gender differences. 

Diet and Iron

        If you have tests low in serum ferritin but not hemoglobin, you may first want to  check out your diet.  Do you eat red meat several times a week or cook in an iron skillet?  It is also important to avoid calcium and any dairy products containing calcium like milk, cheese, yogurt or ice cream within two hours of eating your iron source because the calcium inhibits iron absorption.  Iron is not easily absorbed to begin with.  You can also get iron in raisins and spinach but their content is not as high as red meat and not as easily absorbed.  If you are not feeling any better after a few week of these dietary changes, then you may want to consider the following iron supplement. 

Iron Supplement

        Over the years I have tried many over the counter and prescription iron supplements.  The best one I have found that causes little stomach distress and also raises your iron levels quickly because it is easily absorbed in a prescription supplement called trinsicon.  It contains B12 and a liver absorption factor and comes in a capsule rather than a tablet.  Take it with a full meal but one that avoid calcium and dairy.  If you have tested low in hemoglobin I would definitely recommend asking your doctor to start you on trinsicon.  If you are only low in serum ferritin, I would try making the above dietary changes first and then if you do not see results, ask for the trinsicon.  Usually after taking 1-2 a day, iron levels can return to normal in 3- 5 weeks.   

Regular testing 

        If you run year round and tend to become low in iron or are taking an iron supplement, it is important to monitor your serum ferritin and hemoglobin.  Have your blood tested every six months to monitor not only for low iron but for too much iron as well.  This is especially important if you are male since men do not have periods and iron build up can add to increased risk of heart disease.  However, women too need to be monitored to make sure iron levels stay in a healthy zone.