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Iron Deficiency Anemia

I am wondering if any other women out there have had recurrent issues with iron deficiency anemia. I was first diagnosed with it last summer after Timberman and had to get an iron infusion. I have been on oral supplementation since and I was doing well until my recent lab tests show a slight drop in Hgb and ferritin levels. My hematologist is predicting they will continue to trend downward and is recommending periodic infusions or go on some type of birth control.

Also of note, I am a vegetarian, but was hopeful that with pretty consistent supplement use I would be able to stay on top of it. I'm not thrilled with the idea of eating much red meat, going on birth control or periodic iron infusions. Has anyone experienced this before? Any insights? 

Comments

  • Hi Claire, I almost hesitate to tell you of my experiences with this... I was a vegetarian for 20 years and struggled very badly with anemia, which got progressively worse and worse. While training for my first Ironman, I ended up in the hospital and almost had to have a blood transfusion, my anemia was so bad. I DNS'd the IM, sad to say.

    After years of wrestling with this and not getting better, I finally started eating meat (my doctors were begging me). Now I eat Paleo, and I eat local, pastured meat, humanely raised. We also have our own chickens for eggs, and buy raw goat's milk locally from a farmer. For the first time in decades, I finally feel like I am in good health, and so many other things improved as well. I think for some women, combining serious endurance training with vegetarianism just does not work. I know I was one of them. I tried everything while vegetarian to raise my iron levels and it just didn't work. Even birth control did not work, I'm sorry to say.

    Finally, after getting this under control, I was able to make it to the start line (and finish line) of an Ironman, feeling healthy.
  • Robin, thanks for your response. I am leaning more and more towards trying some locally raised meat a couple times/week over the next couple months and see how my next tests come out. My last resort would be to go on birth control, knowing how many side effects can arise with those. I realize too that, as you mentioned, some women in endurance sports will naturally be prone to more anemia-related issues.

    As a side note, I was given duck eggs from a cowrker about a year ago and had significant nausea and vomiting any time I ate anything containing them (yes, I did enough experiments to know it was the eggs). It concerns me that maybe j would have a similar reaction to meat raised in the same manner. Seeing as you huh your dairy, eggs and meat locally, have you encountered this? It might thwart my meat-eating efforts if it is a problem. Thanks again for your input.
  • Make sure if you start to eat meat, even locally grown, grass fed etc that you ease into very very slow. I have seen people who eat meat but very little try to add some and they have stomach issues with it. Also look at the ways you prepare it as it may effect your stomach as well.

    I would hope with the addition of a small amount of meat and some supplements you would be good hopefully.

     

    Also you probably already checked but make sure there is no other underlying issue you have.

     

    Good Luck

    If you need help cooking it let me know I can help you out.

  • Another Vegi girl here (really "pescatarian" or however they spell it since I eat fish). I had low iron anemia several years ago as well and was put on those aweful supplements that really made me constipated, but it worked. I am on birth control- but I was back then too- so apparently the BC pills aren't always the solution. The two changes I made which seems to have kept my iron stores in check were to make sure I get iron rich vegis in some form every day (I honestly wasn't very good at that part- despite it being so obvious), and believe it or not, to cook nearly everything in a cast iron skillet.

    I'll second Officer Ford's recommendation for taking it easy if you do start adding meat back into your diet. You probably already know that- but I can vouch for just how painful it can be to have even just a few small bites of red meat stuck in your stomach for several days.
  • I definitely think it's a good idea to take it easy if you start eating meat again. I started back to eating meat very slowly and eased into it over a matter of months. It honestly took some time both emotionally and physically to come to terms with it. But after an adjustment period, I found that there have been no issues whatsoever. I can eat a big ol' steak and not worry about it at all. My digestion is so much better now, it's amazing. Part of that is probably taking all the legumes, beans and soy and such - out of my diet - gas and bloating were then gone.

    One book that really helped me through this period was The Vegetarian Myth by Lierre Keith. The author was a long time vegetarian and vegan, and she went through most of the health problems that I also suffered. So I could really relate to her journey, both her concern for animals and desire to be good to them and to the environment, and also her struggles with reconciling that with what was happening in her body.  Also the feeling of having "failed" at vegetarianism and the well-meaning advice from other vegetarians that suggested if I just "tried harder" it would've worked out for me, that I had failed the vegetarian diet instead of it faling me. I also feel strongly now that my current diet is both better for animal welfare and better for the environment than it was when I was a vegetarian.

     

  • Thanks for the input. I made my family's tomato sauce recipe today (which includes ground beef and pork). I plan on starting small, with meat prepared in a way I at least used to eat. I'm not sure if that's what Steven and Nemo were referring to, but it simmers for about 4 hours, so it should also be cooked pretty thoroughly. I plan on freezing most of it, just eating half a meatball to start...hopefully it'll go ok.

    @Steven- If I have problems with the meat I cooked today, I'll be sure to post!

    @Nemo- I'm pretty good about getting a variety of veggies in every day, but I will try to focus on more iron-rich sources. As I'm sure you know, the amount of iron your body actually absorbs from those sources is so much less than meat, it's a modest gain. I'll try anything at this point!

    @Robin- That book sounds like a good read. I do struggle with going back to eating meat. I think it helps that I'm starting with a recipe I grew up with, I went to the local farmer's market to get the meat and I don't plan on eating meat outside my home, so I can still control the circumstances. I have been reading a variety of books about food (Omnivore's Dilemma; Animal, Vegetable, Miracle; Forks Over Knives) and have been moving towards this for a while, it really has been the mental hurdle of having meat sitting on my plate in front of me. We'll see how it goes. I just hope all of this makes a difference!
  • You are doing it right, prepare it the way you remember it and very small amounts to start. The problem I encounter most when people say they don't like things is they don't like the way it was prepared.

    If you need some reciepe ideas let me know we can take it off line and work with you.

  • Yeah- small amounts at first, that's the key. Don't overload your system by sitting down to a huge steak on the first day.
  • I've still only had that one portion of meat...I know I should probably be eating it more, but I'm so used to eating/cooking vegetarian that it's what comes natural now! Plus, I'm not thrilled with the idea of eating it in the first place! I'm thinking I will try to make it a weekend event for a little while and see how it goes. Going to step up to a full serving of ground beef this weekend. Thanks for all the suggestions and feedback!
  • How is it going Claire?
    Like Nemo I am a pescatarian. I guess I have been lucky- so far. But I have not trained for an IM without eating chicken, so things could change.
    Good luck.
  • Sorry I missed this when I went to make my post on iron testing today. Thanks for the info - nice to know we are not alone! I need to get my arse into the women's forum more often 'cause you gals rock! xoxox
  • @Michelle- I am still taking my supplements 3x/day and sticking with eating meat at home from local farms about once/week. I have to consciously think about getting a serving of meat though, and to be honest, sometimes it's a struggle. I have felt about the same for the last 4-5 months, despite my lab results, so I'm hoping adding some meat will show on my next labs in another month or so. In terms of training, I am not seeing any excessive fatigue, so I don't think it's getting significantly worse.

    I only trained for a HIM last year too. I think I had some underlying Fe+ deficiency because I started to notice chronic fatigue and a decline in my training about this time last year. For that reason, I'm trying another season of halfs. I am interested to see how training goes if I do an IM next year. I know some of the guys follow a vegan diet, possibly some of the females as well, which makes me think there is some predisposition to issues with anemia or they take chronic supplements. Please keep us updated on how your season goes!

    Thanks for checking in!
  • Claire, since you are under the care of a hematologist it sounds like you've probably had extensive work up for your anemia, so I'm throwing this out there just as food for thought... My sister was also a vegetarian for a number of years and struggled with chronic anemia. She was on BCP, iron supplements, IV iron, you name it. Even after reintroducing meat, she could not keep her iron stores up. She was later diagnosed with celiac disease, and since going gluten free has finally improved. I think gluten intolerance is poorly understood in the endurance athlete, and could easily be missed. Not everybody that is intolerant to gluten has the true allergy like my sister does, which makes diagnosis difficult. FWIW, here's another puzzle piece for you to consider, and I hope things improve for you soon!
  • Quick update: My most recent labs still have my ferritin level too low, so I'll be getting another iron infusion. I was hoping to put it off, but as I've already started training for my first HIM, I didn't want a repeat of last year.

    I will continue to eat meat occasionally. I just can't bring myself to drastically change my diet right now. It sounds like from what people have posted this isn't necessarily just due to my diet either. It's a process and I will re-evaluate in the coming months.

    Thanks for all the feedback!
  • I am a vegan and have not had any iron deficiency issues while endurance training. 

    I would suggest instead of eating meat that you focus on higher intake  of iron rich fruits and veggies.  In addition to what you would normally eat, start your day with a juice/smoothie including spinach/kale etc.  You get much more iron from spinach then you can get with red meat, and with zero fat. 

     

  • Clarie, I am not a vegetarian, I eat meat regularly and I suffered from anemia for years. It was a huge issue for me, and then I took gluten out of my diet and I know longer have to take iron pills. I have not taken iron for over 2 years and I train for half ironmans. I did come up Vit D deficient 3 years ago, but am no longer deficient in that since I took gluten out of my diet. For me, that was the ticket. I get my carbs from root veggies and am doing great that way. Might be worth a try.
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