Sunday, April 7, 2013

The Heavy Metal Blues

These last two weeks have been quite a ride. After having such a great training week and race at the Across the Bay 12k two weeks ago, I fell off of the ledge. Luckily, it was a short ledge.

I had a workout scheduled for the Wednesday following the race and had to delay it by a day because I felt like I hadn't recovered fully from the race on Sunday. I did the 10 x 800m workout, but it wasn't stellar. I shook it off and ran a long run Sunday that felt a lot harder than it should have. My whole body ached after that run and that is really unusual for me. Long runs are my bread and butter workouts.

The following week, I was having trouble running 8 minute pace on my easy runs. Again, my Wednesday workout was postponed, but I couldn't muster the energy to try it on Thursday either. During my easy run Thursday night, it hit me. I realized that the last time I had felt this way was when my iron stores were low.

You can read about my history with low iron stores in this post. To summarize, I have had to supplement pretty heavily with liquid ferrous sulfate just to maintain a level that is still considered low by some.  Last summer, I experimented with taking a different form of iron, Feosol tablets. I had my iron stores (ferritin) tested at the beginning of the summer and then, in between, started using the Feosol while still taking the liquid iron on and off. My levels remained in the high 30s, which is good for me. At some point I started only taking the iron pills. Why did I switch? The liquid stuff is nasty. It tastes nasty. It stains my teeth. It backs up the plumbing.

About a month ago, I started taking a multi-vitamin that had calcium in it. Trouble is, calcium inhibits iron absorption. I was taking both pills together. Add in some heavy training and you have a recipe for low iron stores. And that is a recipe for sluggish running and injury. Another symptom that made me think low iron was a foot niggle that was not getting better, even with treatment. Low iron stores make it hard for the body to heal too, so there is a really high risk of injury if training continues at a high level.

I confirmed that my iron stores were low a little over a week ago. I also looked at my history and saw an interesting pattern.

Jaymee's ferritin history 1997-2013

Most coaches believe a ferritin level of 20 is the point where performance is seriously affected but it varies for each athlete. Some can get away with levels in the teens and still have decent races while others can't get below 30. That's why I made this chart. It tells the story of my iron levels plotted against my performances. I also know how I felt during those times which is what helped me identify this as my problem last week. I think I caught it just in time. 

The chart shows that my ferritin levels never really get very high even with a solid supplementation regime. When I'm training hard, my levels tend to decline pretty quickly. What also seems apparent from my chart is that there's a fine line between levels that contribute to my injuries and when I perform well (TCM = 2:46 marathon and OTQ = 2:45). My current level of 26 is the same as it was the two times I've had major injuries and that's scary. On the up side, I only need to get my levels over 30 to feel normal again. I am back on the liquid stuff to make that happen as quickly as possible. I have been able to get my ferritin to improve from 21 to 34 in 30 days by taking it 2x per day. Add in a lower training volume and I should be good to go for Eugene.   

It's nice to have been tested every 6 months so I could make a chart like that one, and figure out where my levels should be. I have to admit that it makes me mad that I still end up low even though I know better. The simple solution is to just keep taking the liquid iron and double up during hard training. Lesson finally learned.

The 10 mile race I was looking forward to this morning went fine. I did not race to my potential but I kind of suspected that would be the case given all of this heavy metal business and the tough work week I had (think 10 hours of hiking each day for two days through poison oak infested forests, climbing 3000+ feet each day--that was my Monday and Tuesday). I don't like making excuses for poor performance, but anyone who's had low ferritin knows the feeling. You try to get your little legs to go faster, and they just won't. It's like a disconnect. The up side is when your iron stores rebound: you feel like someone has given you a boost of adrenaline. I'm looking forward to that and hope it comes before my marathon.

SacTown 10 miler awards ceremony.

My race time at the SacTown 10 miler was 1:01:55. I won the masters title for the third race in a row this year. That was satisfying. It was a great race and really well organized. I got to share the stage with Olympian Kim Conley for the awards ceremony. So, that's something. We both got these lovely engraved platters, though she won a little more cash than I did!

I'm hoping I will start to feel a little better in this next week of training. It is my last high-mileage week before I taper. I am hoping for some good marathon paced workouts to build some confidence before I start to let my body absorb all of the hard training I've done this cycle. Regardless of how the marathon ends up going, I know that I've worked hard and become much fitter in the last couple of months. I've gained confidence in myself and my coach and can carry that forward into the next marathon cycle.    
Don't forget to take your vitamins!


  1. Interesting. My ferritin level is at 10, and I feel fine, or at least I think I do. I just got it checked as part of a routine check (well, not routine, bc I haven't had it checked in years, and it was low years ago when I had it checked). Interesting to read that levels in the teens cause sluggish performance in most. I'll be doing IV iron infusions to get mine up quickly, so hope I do feel a difference. I've got 2 50 milers the next 2 weekends and would rather not have this in the back of my head as an excuse.

    1. Hi Amy, 10 seems low, but only you know what that means for your performance. Sounds like you're taking care of it, so it will be interesting to see how you feel once your levels are higher. I have heard of and know athletes who function fine with low ferritin levels (in the teens). I think the biggest risk is actually becoming clinically anemic once your body runs out of iron stores. That will absolutely affect performance and take a lot longer to recover from. Good luck in your races!

  2. Haven't commented in ages because blogger stopped letting me post anything - we'll see if this works! Just wanted to say hi, and great that you caught this before you ended up with an injury. The feeling you have that your legs won't move you feel like your lungs are fine and your heart could beat harder, but the legs just won't cooperate to let that happen? Because that's how I've been feeling lately and I wonder if it has anything to do with my ferritin level of 16. (Pregnancy: the gift that never stops giving!)

    1. Blogger caught on to you, did they? I'm glad they're letting you socialize again.

      It's more of an overall body fatigue including labored breathing. Just jogging up a short hill had me winded a couple of weeks ago. The heavy legs are definitely the most annoying symptom for me. My brain also seems ot be affected, or at least that's what I blame my forgetfulness and inability to concentrate on.

      The best way to find out is to get some iron in your body. I take the ferrous sulfate elixir with OJ 2x per day. It takes me several weeks to start to feel the effects, but can take over a month to really rebound. I'm hoping for just a few weeks.

  3. (maybe none of the following is any news to you; good luck to your race in any case!)

    a tip for taking liquid iron without it staining your teeth - use a drinking straw! that worked great for me when I had to take liquid iron. no problem with the teeth and I didn't even get to feel much of the nasty taste this way hehe :)

    I also added vitamin C powder into the mix, that made it a more sour taste, less of the original nasty taste... vitamin C helps a lot with iron absorption, optimal if you add about 7mg vitamin C for each mg of iron.

    as for "plumbing" - if you meant toilet issues, I found eating extra fiber helped me (when I got off that, I was still fine so I guess my system got used to the iron, whatever). of course I was not eating it the same time the iron is taken, or it will interfere with the absorption of iron.

    1. Thanks for the reminders! I've done all of these things and they can help mitigate the nastiness of the stuff. I guess I just like to complain. The only one that doesn't work for me is the fiber. For whatever reason, it doesn't free things up, if you will. But, I'd rather have all of those problems than deal with the sluggishness of low iron stores.

  4. Great title!

    Yes, good that you've had regular checks to come up with that chart. Interesting how individualised low iron stores are -- the different 'tipping points' of various runners. Don't know if you saw the twitter link to Steph Twell's low iron over a number of years? -- she still managed to improve in spite of that problem -

    Anyway, hope you're feeling back to normal soon.

    1. Thanks, Ewen. That was an interesting article. I hadn't seen it before. I didn't read the actual scientific paper so I don't know how they characterized the results, but I am not surprised that their data, at least the way they presented it in the article in Runners World, didn't show a correlation between performance and ferritin levels. If you were to plot my ferritin levels against my marathon times, the chart would look similar. I continued to improve even with levels chronically in the low (<30) range. What seems to be most important is what your level is at the time of the individual performance. It would also be interesting to see a chart of ferritin levels and perceived effort for workouts and races. This seems to be a problem that varies a lot by individual. It's also one of those evidence-based sports medicine problems that is very real for those who experience it (and their coaches) but seems to have the scientists stumped as to mechanism. For me, I'm happy to conduct my own little experiment and strive to be smart about keeping my levels above 30. I know that works.

  5. Hi Jaymee,
    I've been a regular reader(very inspiring) & am also running Eugene. I just wanted to wish you good luck on Sunday. I wish I could see you finish, but I'll be way behind you (hoping for a 3:30). I did get to see you run in Chicago when you qualified for the trials & cheered for you then.

  6. Jaymee,
    This is so helpful. I just got my ferritin checked after reading your post and a couple of others. It is a whopping 22. Funny because I had no injury leading up to and after Boston, but trying to start adding some miles in after recovery and I have a hip that just won't get better. I am taking elixir in OJ and was wondering how much you take, or if you could point me in the right direction. I want to do it safely, but I'm ready to start adding the miles! Thanks!

    1. Hi Teresa,

      Glad you got it checked! That feeling is so familiar to me. Luckily, you can turn it around pretty quickly with the liquid ferrous sulfate. I use the recommended amount, I think it's a teaspoon, mixed with my OJ. If I can handle it, digestively speaking, I do that twice per day. I am down to once per day now since I haven't been training hard. I'll bump it back up to 2x per day once I get int harder training in the summer. We lose iron in sweat, and Sactown is hot! Try to retest in a couple of months after you're feeling good again just so you have a sense of how you feel at different levels.

      Good luck!