jzs &Sarah wrote:
Thank you for your very quick response from my post! I would like to update you with Sarah's new blood results & see if you have any further comments. The first blood test was from July 11th, 2005; new results from the last test from Aug 12, 2005 are as follows. We don't have the Transferrin Saturation in front of us, sorry.
Serum Ferritin is now 22, the scale being 11-307; in July it was lower than 10.
Hemoglobin is now 12.8; in July it was 12.9.
RBC is 4.25; in July it was 4.27.
Hematocrit is now 38; in July it was 39.
Total Iron is now 198!!, range is 28-170; in July it was 39.
Her training is half as much as before & we followed the advice to take liquid iron.
As you can see her stored total iron is now off the charts but her Serum Ferritin is just in the lower end of the correct range.
Sarah is chomping at the bit to start training harder, she is feeling much more rested & able to run faster without as much fatigue. If it is possible she would like to break 5 minutes for the mile indoors this winter season which will break the WR for Females over 45 (5:08.55), as last year March, 2005 she ran 5:07.2.
Thanks,
John & Sarah Stiner
jzstiner@zoom-dsl.comEx Phys Doc wrote:
A doctor should never down play anemia, and I am not sure how they could have come up with your iron count being too high, when Ferritin was only 22. Ferritin can only indicate iron deficiency-not anemia.
It is also hard to base your iron status just on Ferritin. You should assess hemoglobin, hematocrit and serum iron/total iron binding capacity (to get something we call transferrin saturation). Together, this can tell a doctor what stage of iron deficiency you are in and provide the appropriate dosage to help you regain and maintain adequate iron status.
When the body does not have enough hemoglobin, it cannot transport oxygen well b/c hemoglobin is the protein responsible for binding oxygen and helping to remove carbon dioxide. That is why with anemia we see a significant drop in maximal oxygen consumption and slower pace at the lactate threshold (i.e lactate accumulates much more so and at slower paces). Thus, the decrement in performance and it also reduces the ability to recover after training. You usually feel tired on a regular basis-despite enough sleep.
Overtraining can lead to anemia b/c it can cause you to reduce food intake without realizing you are doing so; so this may be where the doctors were going with that.
Here are some general guidlines for iron status based on stages:
Stage one iron deficiency: Ferritin < 20 ng/dl. Takes approximately 1 month to come back from it.
Stage two iron deficiency (erythropoiesis): Ferritin < 20 ng/dl, Transferrin Saturation < 20%, Serum Iron < 60. Takes approximately 8-12 weeks to come back.
Stage three iron deficiency anemia: All of the above plus a hemoglobin less than 12 g/dl and hematocrit less than 38% (for athletes; non athletes they usually use 36%). Usually takes 4-6 months to fully come back.
The time it takes for someone to come back from any decline in iron deficiency is always individual but is often dependent on their willingness to increase iron intake in the diet-usually red meat since this offers the greatest form of the most absorbable iron.
Hope this helps