If you have spent as many years as I have as a long distance runner you would understand that whenever I hear anyone talk about checking their iron levels, I immediately assume it means that they are checking to see if their iron scores are too low. Low iron is a common concern for runners since we lose it through sweat, from foot strike hemolysis and also through the GI tract. If you are a female then you will also lose even more iron through monthly menstruation, which makes iron deficiency an even more common problem for women than men. Proper iron levels are important for running since our red blood cells contain hemoglobin, an iron containing protein, which transports oxygen to the muscles. If we don't have enough iron and hemoglobin then we will be getting less oxygen to those working muscles. The warning signs for low iron are an increase feeling of fatigue during more intense training, decreased recovery times and basically feeling miserable when trying to log your normal weekly mileage.
I’ve always considered myself to be one of the “lucky” ones because I’ve had consistently healthy serum ferritin scores (ferritin is a protein within your cells that stores iron and releases it when your body needs it), even when training at 8000 feet of altitude! Side Note… Altitude exposure increases your body’s need for iron to support the accelerated production of red blood cells. This will draw on your iron stores so it’s important that they’re at a healthy level prior to altitude training. It was nice never having to worry about bumping up my supplementation or intake of iron rich foods during heavy training stints. However, I had a bit of a shock after some blood work I had done in early 2016. The blood draw was taken about 2 weeks after I had been very sick so I had some odd results. I had some very high inflammation markers and a serum ferritin score of 225 (Whoa! this was by far my highest ever). I figured this was due to the illness but I set up a Skype consult with a naturopath just in case. I learned that during illness the body takes circulating iron out the bloodstream and puts it in storage (ferritin). This is because bacteria and viruses need iron to survive just as we do, so the body tries to make it unavailable by moving it out of circulation.
The naturopath told me I should probably stop taking my iron supplement and asked me at what age did my mother go through menopause (Wait….What!?!). Keep in mind that at the time I was training every day with the BAA elite ladies who have an average age of about 24, so thoughts about menopause did not occupy my headspace! However, it did encourage me to do some more reading about iron levels…
Outside of people who have the genetic disease, hemochromatosis, I found out that most adult men and postmenopausal women tend to be at a high risk, as they don’t have a form of monthly blood loss. The next question I’m guessing you’re asking is why is having excess iron so bad if we need it to survive? Well, among other things high iron levels can permanently damage your organs, tissue and joints, and increase your risk of cancer and heart disease. This excerpt from Dr. Joe Mercola’s recent book, Fat for Fuel: A Revolutionary Diet to Combat Cancer, Boost Brain Power, and Increase Your Energy summarizes the effect of excess iron:
Through a process called the Fenton reaction, excess iron acts as a catalyst and transforms the relatively harmless hydrogen peroxide to hydroxyl free radical (OH-). Without question, this is one of the most dangerous reactions that occur within your body because the hydroxyl free radical decimates mitochondrial DNA, proteins, and membranes. It also contributes to increased inflammation throughout your body, which is a precursor to all manner of chronic diseases.
Since we certainly don’t want this, what can we do to lower our iron?
- Donate blood
- Get a prescription for therapeutic phlebotomy
Things to avoid or minimize that can increase iron absorption:
- Alcohol consumption
- Red meat
- Sugar
- Cooking in iron pans
- Processed foods that are “fortified” with iron
- Vitamin C Supplements
Things to consider adding that can block iron absorption:
- Black Tea
- Coffee
- Calcium Supplement
I realize now that as I both get older and log fewer miles, I will need to monitor my iron levels for the opposite reason that I did during my entire running career. I encourage athletes to get blood work done 2-4 times a year, and in terms of checking iron levels it’s important to include the serum ferritin test, which measures the amount of ferritin in your blood. What I always considered an asset could become a liability if I’m not careful. The naturopath that I consulted with last year was thinking ahead and realizing what I would need to be cognizant of in the future. Prior to my whacky blood work I had never thought about iron levels from the perspective that too much could be a bad thing. This reminds me of the importance of occasionally taking a step back, out of our own microcosms, and look at things from a broader perspective.
Note: For more information on this subject I’d suggest reading Dr. Joe Mercola’s latest book, Fat for Fuel: A Revolutionary Diet to Combat Cancer, Boost Brain Power, and Increase Your Energy, Chapter 4, specifically, is titled The Surprising Effects of Iron on Mitochondrial Health.
Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.