Runners: Low Iron

I've dealt with this same issue and what worked for me was:
Eat red meat 3-4 times a week,
Throw in a cup or two of spinach with my eggs for breakfast,
Started eating the Kroger brand of Ezekial bread for lunch sandwhich(OT poor raising a kid, can't afford 8 dollar name brand bread)
On run days I'll eat Oatmeal as well
That usually adds up to 15-20mg/day on average which got me right.

Actually quit caffeine over 20 yrs ago.

Get your iron levels tested: ferritin, serum iron, tibc, transferrin saturation. This will tell you if you have iron issues.

Taking iron supplements without knowing if you need them can cause other issues.

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Lady at the blood center suggested supplementation with iron along with orange juice to aid in absorption.

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Taking health advice from some trashy fricker that gets paid $15 an hour to draw blood is certainly one strategy

I've had low iron for years now. My doctor isn't concerned as long as it stays where it is. I'm just below normal levels on the test.

For the last several months, my running had really turned to crap.

I thought I had just plateaued or something until I started to really struggle to maintain my pace/distance.

Then I started having random physiological symptoms and went to see my PCP.

He did a slew of bloodwork and come to find out- I’ve got Malabsorption Iron Deficiency Anemia and have had to have two iron infusions last month.

Apparently out of nowhere my body just decided it doesn’t want to metabolize iron any more so I’ll have to get infusions every now and and again going forward.

It’s only been about 10 days from my last infusion and while I’m not craving ice like a crazy person anymore, I’ve not yet been out for a run. It’s also been hotter than balls and I’m trying to allow my body time to catch up.

My next appt with the Oncologist/Hematologist is for Sept. and he will decide when I’ll need my next infusion.

So if y’all are noticing things - don’t write them off entirely. Maybe you need to have a complete work up done.

I’ll be the first to admit that I don’t get a lot of Vit C outside of vitamins. Rarely am I eating any citrus. We do steak at least once a week, but mainly eat chicken or pork.

Last two times I’ve donated blood, they had to double check my iron before allowing me to donate. Think their cutoff is 13? Whatever that means.

If it were me, I'd want an actual CBC and iron panel instead of just a spun crit which is what they are doing before you give blood and isn't going to tell you a whole lot. There is a good bit that should be investigated if you do indeed have a chronic anemia, even (and perhaps even especially) if you are healthy.

You increased oxygen demands are likely leading to increased red cell turn over and increased iron loss through a number of mechanisms. This is an over simplification, but you get it.

Iron is inherently difficult to absorb and a person will only absorb a very small portion of elemental iron taken in orally via supplementation. Excess unabsorbed iron is problematic for a number of reasons and will not do you any favors.

Vitamin C does indeed facilitate iron absorption in the gut, but again there is only so much your system will absorb in a given time period. My specialty is one that I have to treat iron deficiency anemia quite a bit and there is very good evidence that every other day oral supplementation works better than daily. This is starting point and if I can't get someone where they need to be in a reasonable timeframe, I am moving to IV iron sucrose or even better iron carboxy maltose. I'm generally dealing with signifcant deficiencies and if you have nothing else going on, dietary iron and every other day supplementation will almost surely fix you.

TLDR: Would make sure that what you think is the problem is indeed the problem, supplement around 60 mg elemental iron orally every other day and increase dietary intake with iron rich foods.

Not all iron supplements are equal and you need to know how much elemental iron you are getting in a particular supplement (ie 325 mg of iron sulfate = about 60 mg elemental iron).

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So do you have a recommendation for iron supplement type/brand for a runner looking to maximize performance?

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A hundred differnt people (medica professionals or lay persons) will give you a hundred different answers here.

I would start cheap with good old iron sulfate 325 mg taken every other day (that will give you 60-65 mg of elemental iron with each dose). I am not a big proponent of telling people to drink fruit juices, but if you don't have calorie concerns, I would consider either taking your iron with a small amount of orange juice (either fresh squeezed or non-calcium fortified brand), or perhaps eating an orange right before you take it. Also, avoid dairy and other high calcium rich foods in the couple of hours surrounding taking the iron.

I would also try to increase dietary iron through iron rich foods and just go from there. This is a pretty simple approch, but I betcha if you have a mild iron deficiency anemia simply from high mileage running this will do the trick.