Oh, the Iron-y!

January was a rough month; I wasn't feeling like myself and I didn't know why. Much of the time I was tired, craving starchy/sugary foods, had very little motivation for anything other than the basics of keeping it together, and everything felt effortful. I was moody and quick to tears. I had mini-meltdowns during run practice (always where no one could see, of course), frustrated at my slow rate of progress. I was feeling depleted after my long runs, as if I had run them at race effort. There were good moments - exhilarating hill workouts, time spent with friends, and Gracie, who can always make me smile, but the runner's high or bit of good mood evaporated quickly and I would return to my gloomy, depressed state. I didn't want to get out of bed in the morning, wasn't looking forward to my workouts, had trouble focusing at work, and only wanted to lie on the couch and/or eat when I had down time. Poor Gracie only got short walks. I had many symptoms of overtraining, but this was puzzling because the heart rate monitoring was designed to prevent overtraining. I reached my breaking point during a warmup mid-January, when I found myself in tears and wanting to turn around and go home, leave the workout, and possibly quit running altogether. I sucked it up and kept going, told my coach I was struggling, ended up having a great workout (hills, how I love thee), but when I found myself in a sour mood again the next day, I emailed my coach, expressing my pent-up frustrations.

I wondered if maybe this was my new normal after my thru-hike, wondered if there was something wrong systemically, wondered if I was just bored after almost six months of base training and no racing. I wondered if this is what getting older feels like (if so, it sucks!). Would there be a time when doing laundry wouldn't feel overwhelming; when I could put away the clean clothes the same day I washed them? Cook dinner and do the dishes all in the same night? When I ran, most of the time it felt like I was sinking into my steps. My back was progressively better, but my running was suffering, along with many other aspects of my life.

Getting Some Answers
On my coach's recommendation, I paid a visit to Dr. Noah Moos, who had helped significantly with some structural challenges over the past year. I ran down my list of issues. He stopped me when I mentioned I'd been on antibiotics for 10 days in December for a sinus infection. He figured the fatigue was a result of an imbalance of gut bacteria following the antibiotics. Made sense to me. My digestion had been "off" since then. The supplements he gave me (probiotics, echinacea, and P-5-P) had me feeling better in a couple of days. Remarkably better. I had energy, my appetite stabilized, sugar cravings dropped off, and best of all, I felt happy for no reason. When I hit three consecutive days of feeling good, I kept telling everyone how I couldn't remember the last time I felt that good for x many days. And it continued. There was power under my legs, and a spring in my step. I had energy to do more than the basics of self-care and run workouts. I could wash/dry/put away clothes, and then bake or make treats for work, all in the same day. It was awesome. Then I ran 3M, which was also awesome. But the recovery seemed to be never-ending. After 3M, I wanted to write about how much better I'd been feeling, but was too tired. Important plot-point: The day after 3M I was rejected as a blood donor because my hematocrit was too low. I didn't think too much of it. Dr. Moos had mentioned that my iron was low, but until my gut flora was stabilized, iron supplements would only fortify the bad bacteria, so we'd held off on those. However, by mid-February I was back in the hole and the original supplements weren't helping. I began to suspect something else was amiss, so I had some blood work done and took the week off from running while I waited for results. I might've been able to run if someone had been chasing me that week, but they would've had to be pretty scary. Meanwhile, it's good that I was so fatigued, it didn't leave much energy to worry about the possible outcomes of the blood work. Most likely was anemia, but low thyroid and a few far-fetched possibilities tugged at my consciousness. I tried not to spend too much time searching the Interwebs for answers.

The Results:
Low hemoglobin, low ferritin (iron storage), high RDW (red cell distribution width), all markers for iron deficiency anemia. Thyroid hormone, and everything else tested was normal. I was much relieved to have a treatable cause for my symptoms.

The Treatment:
Twice daily iron supplements, recheck levels in 6 weeks, scale back training, cancel New Orleans half trip, eat lots of iron-rich foods (except liver, for now), cut back or eliminate foods that inhibit iron absorption (coffee, tea, chocolate!), rest, and let my body recover.

Next up: I've never had anemia issues, and I'm not vegetarian, so how did I get to this point? I have a theory...