Disclaimer: This is my personal story and not meant to be medical advice. Please consult your doctor if you have health concerns.
I recently went through a nasty bout of low ferritin (iron deficiency) and vitamin D deficiency. It didn't just affect my running. It affected my whole life and other aspects of my health, including asthma and allergies. This is my story.
First, some background...
What is low ferritin?
Low ferritin means your total body iron is depleted, meaning you're iron deficient. Symptoms of it include shortness of breath, fatigue, unexplained weakness, chronic headaches, exhaustion, brain fog, and a bunch of other unpleasantries. It can be more common in women, vegetarians, and runners. And I'm all three (mostly - I eat fish occasionally).
And why is Vitamin D so important?
The sunshine vitamin keeps lots of things from going awry. Symptoms of low Vitamin D include muscle weakness, bone pain, constant respiratory problems, chronic infections, chronic pain, tiredness, increased inflammation (which in my case, made asthma worse), and reduced endurance.
All of those symptoms listed above? Yeah. I had them. But they didn't come on all at once. It was a gradual progression. Low ferritin and low Vitamin D combined created a perfect storm of issues for me and because I already was dealing with asthma and allergies, I didn't even realize what was going on for quite a while.
The long downward spiral
This wasn't just about being tired or sore after working out, or having a few bad races, or even the kind of tired that comes from cumulative overtraining. This was something else entirely and as you can see from the list above, there are lots of unpleasant symptoms.
At first, it was easy to miss or blame on something else, like stress or lack of sleep or parenthood. It wasn't like I went for a run one day and suddenly felt inexplicably tired, or even had a few bad runs in one week or a bad race. This was a months-long progression of getting slower and slower, more and more tired, and unable to recover from things I previously had no issue with.
I also experienced increasing intense brain fog. Sometimes I'd sit in front of my computer and feel like I couldn't get to my thoughts, as if there was a screen in front of them making everything blurry.
And that caused even more problems with my already out-of-control asthma and allergies. While my asthma and allergy issues started getting bad in April 2015, looking back, I believe my issues with iron and Vitamin D started in early 2016 with some slight problems that surfaced as getting sicker more frequently and being unable to get faster but still maintaining current paces.
It wasn't until the summer of 2016 right around the time of the Floppin' Flounder 5K that I think it really started to get bad, to the point where I wasn't even maintaining my current paces. I was getting slower. Significantly slower.
At that race, I logged a race time that was much slower than the prior year. At the time, I chalked it up to the fact that I woke up with a headache and experienced super sensitivity to heat and humidity.
And then I ran another race (the IOP Beach Run) and logged another slow time. And then I ran a trail race that also wasn't my most stellar of races. Since both of those were on non-road surfaces, I just blamed it on that (even though my current 10K PR was run on a beach and I know I'm capable of sub-8s on the sand).
And it just kept getting worse.
In September, I ran the Turtle Trek 5K Beach Run and had a massive asthma attack that resulted in a visit with the medics in the ambulance (my son still talks about how mommy was sick and he was scared).
I still chalked this all up to heat, humidity, asthma, and sinus problems, even though I found it odd that I was running so much slower than the prior summer when I was also having asthma issues.
I started to suspect that perhaps something more was going on when I ran the Disney Wine & Dine half marathon with my friend, Jenn, and was absolutely exhausted afterward. Considering we ran the Disney Half back in January 2016 at the exact same pace on almost the same course (and our pace was slower than I normally run), and I had absolutely no issues with that, I thought something was off. I was more tired after running the Wine & Dine race than I've been after half marathons where I've PR'd and I had weird aches and pains (not muscle soreness, outright bone pain). But I was also under a lot of stress at the time, too, so I thought it probably was just that.
All along, from late summer on, I was also experiencing really odd aches and pains - full body aches like I had the flu, aching joints, fatigued muscles. And I was constantly sick with sinus infections and upper respiratory infections. It seemed like as soon as I got better, I'd get another one and they kept getting more and more frequent.
Then I ran the Turkey Day Run and could barely put one foot in front of the other. I ran it a minute and a half slower than I did while pregnant and over two minutes slower than 2015 (when I was also sick and not feeling well). That's when I knew without a doubt that something more than asthma and allergies was going on.
I went to the doctor who tested me for literally everything they could based on blood tests, including thyroid issues, anemia, and diabetes. My results came back with bottoming out ferritin, hemoglobin that was only a point into the normal range (any lower and it would have been full-blown anemia), and practically no Vitamin D. None. I had problems.
So what caused all of this?
I'm not sure specifically. It was a range of things.
I do know that 2016 was a horrifically stressful year and stress can contribute to these types of problems. I'm also a pescatarian and only eat fish once in a while. I don't drink milk ever or eat other dairy products often. I wear sunscreen. I'm a woman of childbearing age. I'm an endurance athlete. And my eating habits were absolutely terrible. There were days where I know I ate, but I couldn't tell you what I ate or when I ate or if I even enjoyed what I ate.
All of that created the perfect recipe for disaster.
How I fixed it
The good news is, it's all fairly easily fixed with the right supplements, rest, and better nutrition. The doctor prescribed three months of iron supplements (starting in mid-December) plus the max level of Vitamin D supplements and told me to come back for a recheck in 3 months.
I also cleaned up those eating habits. I started logging my food intake, making sure I wasn't just randomly eating tortilla chips or brownies for lunch. And toward the end of the 3 months, I started a new multi-vitamin.
By the time late February rolled around, I started to see some improvements. I could push myself in barre classes again and no longer felt like I had to take it easy. Running was still hard, but daily life was much easier. I had energy to do things again, and the brain fog lifted.
When I went back to get rechecked, I was back in the normal range for everything. I was fortunate that I didn't have major issues with the iron supplements since they can cause digestive issues and it often takes trying a few different ones to get it to stick. My doctor prescribed Integra and they worked fine for me.
The entire time I was recovering, I cut way back on running and got all races off my calendar. It was just extra stress and pressure I didn't need while I was trying to get well.
Where I'm at now and what's next
Over a year after I believe the issues began, I'm finally starting to feel like my old self. I'm back out running 4 days a week and I'm hoping to get to 5 days. Then I'll also add in more strength work for crosstraining.
I'm no longer on iron supplements (as of three weeks ago), but if I start feeling like I felt before, my doctor will get me back on them. Generally, it's not great to be on iron supplements for a long time and most people don't need that, so if I can manage this with my diet and nutrition, I'll be much better off.
As for Vitamin D, I'm still taking those supplements. I may have to take those forever. And I'll be sticking with my multivitamin as well. I take Ritual, which has a good list of ingredients for people like me, including iron. I also like that it's vegan. Lots of people don't need a multivitamin, but as a (mostly) vegetarian endurance athlete, it's probably smart for me to take one.
And of course, I'll be paying attention to my diet. I've been making smoothies, ordering meals from Hello Fresh since they have balanced vegetarian entrees, and just generally eating better. Nutrition really is the key to keeping all of this in check. Vitamins and supplements are just that: supplements. I have to eat well. Food is fuel, right?
I'm also getting allergy shots, which don't have to do with the ferritin and Vitamin D problems, but they are helping with the asthma and allergy issues. I'm about 3 months in and I'm already seeing improvements. I've dropped two of my allergy/asthma meds already and I hope to drop a few more in the next year or so.
While this past year has been really hard, I'm so glad the issues I had were fairly easy to fix. I know it could have been much worse and much harder to get straightened out. I'm not completely better, but I'm getting there and I'm hoping that by taking the summer to rebuild my lost endurance, I'll be in racing condition by fall.