Wednesday, August 11, 2010

Genetic gifts and booby prizes

Self portrait of me and my Mom at the park.
A man asked me the other day after hearing me perform in a concert and learning about my running success if I felt guilty for having so many gifts (he asked this just before he asked me out, so take it for what it’s worth).  I think I gave him an “awe shucks” response and probably blushed appropriately.  He is right that I have been blessed with many amazing gifts, and I cannot deny that good genes play a major role in my running success.  But, I have been awarded some booby prizes too, and I was reminded of a couple of them last week.

I completed my two-week annual military tour with the US Air Force last Friday.  During my annual tour, they do a cursory physical assessment to ensure I’m fit to fight.  The assessment includes a blood panel, and I always ask for an iron test, specifically a serum ferritin test, since I struggle with low iron stores.   I consider this tendency toward borderline anemia to be one of those genetic booby prizes.  I have posted about this previously, so if you want more details, please refer to my bitter irony post from last year.  

In 2007, my levels were low (12 ng/ml), and it took me about 6 months of iron supplementation to recover to the point where I felt good training hard again.  It took even longer before I was racing well.  I have been pretty consistent about taking my iron supplements, but about 6 months ago I started to take the iron every other day to see if I could get rid of some of the nasty side effects (plumbing back up, stained teeth) that come along with it.  I had my ferritin levels checked around that time and they were 27 ng/ml.  As my coach put it, they were dangerously low since the general rule is that a reading below 20 can affect athletic performance.   So, I needed to be taking more, not less of this stuff.  I was in Whole Paycheck one day and noticed that they sold a plant-based product that promised it would not back up my system like I suspected the ferrous sulfate elixir was doing.  I bought a couple of bottles and took double the recommended dosage daily.  My test results last Friday showed my ferritin levels had dropped down to 21 ng/ml on this new supplement.

While I am training well right now, this low level is likely affecting me in some way whether I feel it during my training or not.  I do know that I will really start to feel it if I drop any lower.  I have already switched back to the old ferrous sulfate elixir and am trying to eat at least one meal with red meat in it per day.  I am so grateful for having this test done when I did.  I just hope that I can increase my iron stores sufficiently as I continue to train hard over the next couple of months in preparation for the Chicago Marathon.

The blood tests also revealed that my total cholesterol is holding steady at just under 200 mg/dL (193), but my "bad" (LDL) cholesterol is over the magical limit of 100 mg/dL (104).  The good news is that my running keeps my "good" cholesterol (HDL) level high at 69 mg/dL.  I know that having higher than optimal LDL levels doesn't mean that I have a huge risk of heart disease or anything like that, but it does make me appreciate how diet and exercise don't seem to affect my LDL reading beyond a certain point.  My levels have been much higher in the past with total cholesterol pegging out around 240 in my early 20s.  But, they have never gotten lower than they are now.  One of the main reasons I originally switched to a low-fat diet (among other dietary changes) was to lower my LDL levels, and it worked.  However, they just won't seem to drop below 100 regardless of what I try, and maybe they don't have to.

I bring all of this up in the context of the discussion that's taking place regarding weight and nutrition in my blog as well as others'.  Restricting caloric intake will certainly lead to weight loss, but I have to be extra careful about getting the proper nutrition.  I track some of the nutritional components of my diet and am always shocked to see just how little nutrition is in a lot of the foods I eat, even fruits and vegetables.  Of course, when I add these nutrients up over the 2300-2800 calories that I eat daily, I generally get the recommended dietary allowance (RDA) proffered by the USDA, but that's really not saying much.  For many of these nutrients, like iron, vitamin D and calcium, I wouldn't even hit the RDA without supplementation because a lot of my vitamins and minerals come from fortified foods like Clif bars, oatmeal and vitamin water.  That's sad.  I can't imagine maintaining a hard workout schedule eating much less than I do right now.  

So, I think about these things when I make food choices.  I look at the cookie under the glass at the coffee shop each afternoon and know that I CAN eat it if I want to in terms of my caloric balance.  But, I also have to question what I won't be eating that might be healthier for me if I do indulge.  The term empty calories has never had more meaning to me than it does at this point in my life.  I am certainly not saying I am a Saint when it comes to avoiding junk food, but I do recognize the trade offs in my food choices now more than ever. 

This week's lab test results were a wake up call.  I was reminded that while I might be meeting my goals according to the numbers on the scale and my reflection in the mirror and even enjoying some great workouts, counting grams of carbs, fats and proteins without paying attention to the rest of the nutritional content of my diet might be doing damage to my body.  This type of damage occurs over a longer timeframe than a typical marathon training cycle.  It's also something I probably won't see until it's too late and presents itself as a random, persistent niggle or even in the form of injury, illness or disease.    

"As someone has remarked, if you are what you eat, it seems the average consumer consists mostly of thickener, water, salt, and sugar."
Harvey Blatt, 'America's Food' (2008)   


  1. Hey! I’m the guy who said that to you! First, sorry to hear about your iron problems. Sounds like you’re working your way through it though. And I also heard you say you had a Phd. That’s when I made the comment. Hahaha, you’re the complete package – intelligent, athletic, and artistic! But in my defense, I was really thinking how badly I tend to feel when I have more than others. I’m just wired differently, that’s all. Tell the Genius I’m harmless. Oh, and I also told your mother what a doll you were…which meant super nice. KB

  2. KB, Wow, I guess I'm busted aren't I? Thanks for the generous compliments. I'm glad you got a chance to defend yourself;) I think perhaps the guilt shouldn't come from having the gifts but in squandering them when you do have them. I work hard to not squander mine and apparently feel no shame in telling complete strangers all about them!

  3. Effin 'J - I'm really glad for you that you'd previously discovered your tendency towards iron-deficient anemia when you had, and have kept a close eye on it since. A few years ago, being a frequent blood donor while running lots of miles I had gradually become less and less energetic - with accompanying slower race times, and - in retrospect extremely foolishly wrote it off to 'getting older' and essentially stopped running. A few months later my mistake was fortunately caught (by the blood service who refused my blood!), leading me with my doctor's analysis to the conclusion that I too need additional iron supplementation. Unfortunately the role of increasingly common iron-deficient anemia adversely affecting runners' stamina hasn't received sufficient recognition, so thanks for sharing your story!

  4. Lucky you didn't tell KB he was a right wally ;)

    That was a timely post. I'm getting the results from a blood test next week. With below 20 ng/ml for ferritin being risky for a female athlete, I was wondering what do you consider "ideal", and what's the range? It was fortuitous that you had that test when you did. Hopefully the new supplementation will get the levels back to where they should be.

    Like KB, I'm also impressed you're making the most of your genetic gifts. Sadly, I've seen numerous young athletes 'coast' on the back of natural talent only to give away the sport when they realise success needs talent and hard work.

    Also, great self portrait. Your mum looks young!

  5. Too funny, being busted with the boy, but how cute all 'round. Glad you got it checked, but man, I do not envy you those side effects. May you get back to where you should be asap! Also, excellent quotation by Harvey Blatt.

  6. Mark, thanks for sharing your story. I'm so glad you made the connection between blood loss and your stamina. I'm also glad you were able to correct things with iron supplements. I appreciate when there's a simple cause-and-effect answer like that!

    Ewen, that's exactly what I thought since that's just what I was going to call him--a right wally;) He's a very nice guy, actually. It would be nice if your problem is low ferritin levels. I don't mean to imply that I hope you have low iron, but it is a nice explanation and there is something to be done about it. Don't expect your doc to have any clue about sports anemia and he/she will likely say that you are in the normal range which is huge, btw. I know my coach likes me to be around 40 ng/ml at a minimum and preferably 70. I have never attained anything higher than 40. And, that may just be how I'm wired. The most important thing is to know what normal is for you and how you feel at different levels. For me, I know that 12 ng/ml is way too low, but where I am now, at 21, doesn't feel too bad. It might be affecting my recovery, and I could have an injury pop up sometime in the future as a result. You can also feel crappy with levels that are too high. So, I'm very glad you're getting tested. Best of luck. I'll be very interested to hear the results, if you feel like sharing.

    GIM-I actually thought a lot about you when I wrote this given your recent posts on tracking calories and weight and some of the consequences of focusing on the numbers. I know you're a smart girl in motion and will ensure your nutrition is taken care of. It is worth reminding folks how much more important nutritional content is in their diet when they restrict calories significantly and that runners have extra special needs that must be met to perform at our best.

  7. Thanks Jaymee. You probably are wired that way re the iron. I see the doc and get the results tomorrow morning, so it's good to know that 'normal' might not be normal for a runner. Don't mind sharing, so I'll post back here.

  8. My iron is 'normal' - haven't got the actual numbers. Problem could be thyroid function, which I'm getting follow-up blood tests for next week.

  9. Ewen: My iron levels have all been declared "normal" by every doc I've seen, but they are not normal for a competitive athlete. I'll be interested in what the numbers say.

  10. Effin' J,
    I shockingly recently started devouring your blog. Thank you for your honesty on EVERY thing. I'll have more questions and comments coming up, but for now I'll throw out a nutrition suggestion after seeing your food spreadsheet: you can have that cookie with NO worry about nutrition.

    Just replace your chips or your bagel or your tortillas with anything much more bang-for-your-buck. Could be as dense as sweet potatoes, or it could be big and 'fluffy' like TJ's Harvest Hodgepodge stir fry mix, or other veggies. RDAs solved, and it's cookie time! :-)

  11. Andrea, Glad you found the blog and enjoy reading it. Thanks for the suggestion. Truth be told, I do get that cookie on days when I run extra miles and feel like I can add the sugar without compromising my nutrition. It's usually an oatmeal raisin, and, as you point out, is probably better for me than the chips and tortillas I throw into the mix now. I look forward to your comments and suggestions in the future!