I’ve been training for a few years now, and started feeling deep bouts of fatigue. I started doing lots of research and saw that a possible iron / ferritin deficiency could be triggering it. I got my ferritin tested and it came in around 20. Some labs flag that as normal, but lots of forums and some studies I found talked about ideal being at least 70, and really wanting it above 100. I started supplementing, and got it to above 100, and felt amazing. Reduced fatigue, reduced anxiety, strong power output. I got lazy on supplements and back down to 55, and have all the symptoms. Doctors have told me it’s not a concern, but I’ve tracked it for 3 years now and can have correlation with symptoms at anything below 75.
The figures I heard was around 135 parts was better than normal (for a bloke anyway) and that could fall to 35 before docs get worried and 15 was a catastrophic threshold. When I did the LEJOG it was 12 and my pre op test 5 or so months later was 9. At 55 going by the numbers I was given your 55 at the lower end of normal spectrum but nothing too much to worry about and nothing you can’t sort out.
After some concerns my daughter, who is a runner, had with this I found some interesting papers. I don’t recall numbers off-hand, but I thought the narrative review was very good for perspective.
(Also, I got these papers from the author - I found them online, but with restricted journal access. I emailed him about the narrative review and he sent me extras too.) Sim et al 2019 EJAP_Iron Considerations For The Athlete PDF (1).pdf (683.4 KB) McCormick2020_Article_RefiningTreatmentStrategiesFor (1).pdf (907.6 KB)
My wife had a problem with this. Her level was 4. She was totally tired and completely miserable the whole time. As soon as she started supplementing and her iron levels raised to normal she was transformed.
A side note on this, especially for women - when dealing with my daughter’s issues, I could not find any gummy vitamins that include iron - including the women’s specific ones, and that is what we had been using. Getting at least some iron in through supplementation is likely a good strategy for many people, especially runners, as I recall from the paper above.
My experience mirrors yours except with a high water mark of 63 (and an initial low of 20 something). It was something my psychiatrist brought up. It’s helped as far as I can tell, though I haven’t been meticulous about tracking it and I do need to be more consistent with iron supplements.
I have scheduled myself a physical after feeling abnormally fatigued for the last month or so, despite good rest and nutrition. I’m talking going up the basement stairs and feeling it in my legs fatigue. Increased RPE and reduced performance versus a month ago on similar efforts/power targets and just general tiredness.
I’m going to ask for my labs to check ferritin levels to rule this out. For those that started supplements, what did you use?
Ironically, my son’s XC coach just sent an email out asking all athletes to get a baseline ferritin level check.
I use the megafood blood builder pill which I’ve been fairly consistent (enough so that I’d bring it on long thru hikes) with and sometimes a liquid iron supplement, though that’s easier to forget/run out of.
I’ve been struggling with muscle weakness and some anxiety (although some of it situational) for the last 2.5 months. I’ve had bloodwork done near the start of it, and everything was more or less “fine” according to typical ranges. I’ve tried adding extra vitamin D supplementation, supercharging my protein intake, time off the bike, carb loading, and so far haven’t found the fix. Just stumbled across this thread and I definitely identify with the “my legs feel like crap even when I just try to walk up the stairs”. My ferritin was 71 in April, wondering if I’m just a hair low based on OPs experience. Might try a little ferrous sulfate for a couple of weeks and see how it goes. It seems like a stretch but I’ve tried about everything so far, and all the little details of my symptoms seem like something iron related. Even wondered with my wife when this started whether I was iron deficient based on the symptoms but thought the blood work ruled that out.
I hear you, but I’ve done recovery weeks and even an entire week off the bike and experienced basically zero change in the sensation in my legs, which suggests something is off, not just accumulated fatigue or underfueling. It may not be ferritin, to be fair, but in 6-7 years of training, the only time I’ve ever felt like this specifically was when I had a vitamin deficiency (identified through blood work by my doctor).
I’m in the same position as you. But as far as I know blindly trying for iron deficiency is kinda pointless since it takes months of supplementation till you experience positive changes. Unlike Vitamin D Iron supplements are also not harmless if you are not deficient.
Yeah I mean you can overdo it on both (D and Iron), but given my blood work previously I’m a long long way from being high on iron or ferritin, so should be pretty low risk, especially for a few weeks. Also realize that iron takes a long time to move, but the studies do state athletes seeing significant increases over 8-12 weeks, so hoping I at least feel a slight directional improvement in 2-3. If not, really not much harm. If I don’t get this sorted soon I’ll head back to the doctor.
I was told by two consultant haematologists that floradix is a literal waste of money - it’s nowhere near enough and not absorbable. The reason it’s easy on the GI system is that it isn’t enough iron to cause GI upset (or meaningfully correct deficiency).
Just buy high dose tablets. If you really realy struggle with the GI - do them every second day or try bisglycinate.
This is one of those areas where it’s worth saying - too much iron is a bad thing. Don’t supplement without knowing you need it, and if you are supplementing you should be doing it based on a blood test and testing periodically.
Now, with that said:
I’ve also heard if you’re taking it, take one with Vitamin C as it helps absorption (Vitron C for example)
And, there are some studies that show better absorption by taking every other day because of what I think is called a hepcidin response?
I personally have gotten down to Ferritin in the 30’s the past two years and am supplementing every other day now, and will test again after 3 months or so. This year I’m taking Vitron C, last year my physician prescribed Ferrous Sulfate (I think) every other day. For me, I’m going to be spending 2 weeks in Leadville at 10,000’ or higher, so especially during that time iron needs are higher.
I went and had an extensive amount of lab work done yesterday and found a couple of things interesting. Still waiting on my testosterone.
The CK level is what stands out. This is an excellent indicator of muscle damage which I would think directly correlates to my decrease in performance and increase in RPE across all zones. I see that my ferritin levels are on the low end of normal. Do I ignore that or start incorporating more red meat and iron-rich foods into my diet?
