I was talking with the head coach of the Massachusetts Institute of Technology’s cross-country and track & field programs, and I asked him what he thought was important for Monta Vista athletes to do in order to be ready to compete as part of MIT’s team. Coach Taylor rattled off several topics to focus upon. Monta Vista track & field/cross-country does try to work on most of these areas:
- A regular stretching program of dynamic (before workouts) and static stretching (after), (MV does both but we can never do too much):
- Core and resistance training (again, we can always do better);
- Reasonable amount of mileage given the athlete’s training age (we are inside his suggested targets).
Monta Vista has a program that matches what the MIT coach suggested.
Then Coach Taylor asked one more thing:
- Do you check the serum ferritin levels of athletes every season?
A serum ferritin test indirectly measures the amount of iron in your blood. Ferritin is an intracellular protein that stores iron and then releases it in a controlled fashion. The amount of ferritin in the bloodstream reflects the amount of iron stored. (Mayo Clinic web site.)
As a public high school we can’t do medical tests on athletes, yet Coach Taylor is adamant about the value and importance of having athletes, especially young women but young men also, tested for iron levels before every competitive season. His unwavering conviction in the importance of iron levels in his athletes, and his belief that ensuring his athletes are at healthy levels, has lead me to do some research about this topic.
Low iron levels can make a runner’s legs feel tired and dead, make it harder to bounce back from a workout, and can lower a runners’ desire to run. Have you ever started a run and just felt like your legs are dead, that there was no ‘pop’ in your step, that running was simply not fun? Since I want all of you to feel great and to love running–I decided to do some research!
My conclusion is that I am going to get my own serum ferritin levels tested, and if you are interested, you might consider getting tested too as part of your next annual physical examination.
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JANUARY 2013 UPDATE:
1. I did get my blood tested. This was an elective test and I paid $34 under my plan. I consider this money well spent for my peace of mind! My serum ferritin levels were tested to be acceptable for an endurance athlete.
2. A few Monta Vista athletes have shared their test results with me on a confidential basis. More than 80% of the Monta Vista girls tested and half the boys had lower than the recommended level of iron for endurance athletes. The MIT coach would immediately require all of these athletes to start adding iron supplements to their diet; others (Dr. Russell Pate in particular) would also recommend diet modification increasing consumption of red meat; everyone would recommend being retested in 6 to 12 months to see if the supplements and/or diet modification was successful in increasing the serum ferritin levels.
3. I have found that some doctors are resistant to performing this test. I think this is a mistake to not want to get the information. This is not a risky test. Having more information cannot hurt and it might help. The cost in minimal.
Please read on…
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Here is some of what I’ve found out about iron levels and the serum ferritin test.
WHY ARE IRON LEVELS ARE IMPORTANT TO ATHLETES?
Iron is necessary for production of hemoglobin in your red blood cells, and hemoglobin carries oxygen from the lungs to the muscles. Your muscles need oxygen to perform well, and to recover. If your hemoglobin level is low, less oxygen reaches your muscles, and your VO2 max (VO2 max is a measurement of your aerobic fitness, and this number correlates to your ability to run fast and sustain that fast pace; VO2 Max stands for ‘Volume of Oxygen maximum) and racing performances suffer. In addition, iron is a component of many other substances in the body, such as enzymes in your muscle cells for aerobic energy production.
If you have iron deficiency anemia, your iron stores are gone, and your hemoglobin level is reduced. With iron depletion, on the other hand, your iron stores are low but not gone, and your hemoglobin is still normal.
Sufficient iron is especially important for endurance athletes, like you. Endurance athletes have more blood than normal people-which allows the stroke volume of the heart to increase. This is a good thing, both for a runner and simply to be a healthy human being. Because well trained runners have more blood than normal people, the iron in a runner’s red blood cells is diluted in a greater volume of blood. If the runner’s red blood cell mass does not increase as much as the blood volume, then hemoglobin concentration will decrease.
What the runner with an iron deficiency will feel is tired, and an inability to bounce back from a hard workout. The runner’s energy level may be down, and the runner’s legs may feel heavy and dead. If you feel like this, the problem may be low iron.
Coach Halston also adds that decreased serum ferritin over a long period of time has been shown to be correlated with occurrence of stress fractures.
DOES RUNNING CAUSE LOW IRON LEVELS?
Based upon the reading I’ve done and the discussions I’ve had with experts, distance running can contribute to low iron levels. A well trained endurance athlete will see an increase in his or her blood volume as they train. This increased blood volume will dilute the iron in the blood unless additional iron is absorbed. There are other factors that may come into play, such as repeated foot strikes ‘crushing’ iron and lowering iron count. Being an athlete can stress your systems and contribute to lower iron levels. More importantly, while athletics does not generally cause low iron levels or anemia; being an athlete helps you uncover or discover existing issues. Finding out that you have low iron levels or a tendency to low iron levels is a good thing, because now we can address this issue and improve your health.
Think of a car sitting in your garage, and the car has an oil leak that you don’t know about. Eventually, the car has no oil. As long as the car sits in the garage, undriven, you will never know that the car does not have any oil. When you get in the car and drive the car down the road, the engine seizes up. Driving the car did not cause the engine to fail; the lack of oil caused the engine to fail. Driving the car simply discovered the problem—and it would have been great to discover the problem earlier.
Distance running may not cause anemia or low iron levels, but distance running does appear to help you discover you have an issue. And that’s a good thing because now we can address the problem and make you stronger and healthier.
WHAT IS A SERUM FERRITIN TEST?
(From the Mayo Clinic’s web site)
A ferritin test measures the amount of ferritin in your blood. Ferritin is a blood cell protein that contains iron. A ferritin test helps your doctor understand how much iron your body is storing. If a ferritin test reveals that your blood ferritin level is lower than normal, it indicates your body’s iron stores are low and you have iron deficiency.
Your doctor will give you specific instructions, but you can expect to eat and drink normally before the test. During the ferritin test, a member of your health care team takes a sample of blood. The blood sample is sent to a lab for analysis. You can return to your usual activities immediately.
There is an expected healthy range of blood ferritin levels and your doctor will help you interpret the result of your test. While normal serum ferritin is a number of 20 or above, anything under 50 will hurt an endurance athlete’s performance, according to Coach Halston and researchers from Tufts and from Mercy Hospital in St Louis.
A ferritin test is not part of your standard, annual physical examination; you and your parents must specifically ask to have this test performed.
WHAT TO DO IF YOU FIND OUT YOUR IRON IS AT A LOW LEVEL?
The first thing to do when you get your test results back is to have a discussion with you, your doctor and your parents, all together. Your doctor is the expert on your health and you should take his or her advice, and your parents need to be involved so they can support whatever your family and your doctor decides the next step is.
I’ve talked to different experts who have offered different perspectives. Coach Taylor requires any MIT athlete tested with a low iron level to take iron supplements, regularly, for the entire season. Our friend Dr. Russell Pate (professor at the University of South Carolina, and an excellent endurance athlete himself) believes that diet modification can increase iron to an acceptable level in many (not all) athletes. Many Monta Vista athletes are just not practicing good nutrition, or trying haphazardly to be semi-vegetarian, or just not eating enough. Some experts say that eating a 3-ounce beef steak twice a week may be enough for many athletes to see an increase in iron to an acceptable level, and others recommend supplements. If the athlete is a vegetarian, or does not eat red meat, supplements may be required to change the serum ferritin level as iron sourced from vegetables is not as readily absorbed by the body.
You are unique, and your doctor is your personal expert. Your doctor should be the source for recommendations for your own personal situation. You and your parents will want to discuss the options of supplements, diet modification, and improved nutrition with your doctor.
In any case, my understanding is that with a few weeks of attention, it is possible to significantly improve your body’s iron levels, which can result in a rapid change in your fitness levels.
OTHER READING
Here is an article by Pete Pfitzinger that I referred to quite a bit as I learned about iron levels. Pete is a two-time Olympic marathoner and exercise physiologist.
BOTTOM LINE AND CONCLUSIONS
I have found the relationship between iron levels and the performance of endurance athletes to be very interesting, and have the potential to identify problems and improve overall health as well as athletic performance. I am very glad that Coach Taylor and the MIT track program has inspired me to learn more about serum ferritin and blood iron levels. Anything that might help our team be more healthy gets plenty of attention from me!
If you and your family find this discussion of iron levels interesting also, you should to ask your doctor to run a serum ferritin test together with your next annual physical. That’s what I am going to do for myself. The result of this test can help you have a conversation with your doctor about your iron levels, your diet, your health and your athletic goals.
APRIL 2013 Addition: Please consider getting tested for your iron levels! The more I learn about this, the more important I think it is to be tested–particularly girls. Having the information can’t hurt and it might help. I’m seeing athletes react positively to iron supplements, and it breaks my heart to see young, enthusiastic athletes feel fatigued when maybe they should not be so tired. Maybe the problem is not iron levels, but we only know if the athlete has been tested and we have the data. PLEASE get your girls tested for serum ferritin levels this summer!
If you do get tested, and you and your parents are comfortable sharing the results and recommendations with me, I’d be very interested. You are under no obligation to share the results with me, or even tell me if you have been tested. The only reason I’d like to know is my desire to continually improve my ability to help you and other athletes at Monta Vista perform at their best. I will keep all information private, I’d only like to be able to provide parents and athletes overview information. For example, next year I’d like to be able to say that ‘last summer, n athletes told me that they had a serum ferritin test, and of those x% had their doctors recommend supplements or dietary changes.’ This information would help us all be healthier and better athletes. Whether to share this information with me is totally up to you and your parents, and please do not share any medical information that will make you feel uncomfortable.
Thank you for your attention to this article, and thank you for you interest in improving your health!