The good news is that I'm not anemic. Yet. The bad news is that even though I've been taking iron supplements twice a day for months, my ferritin level has fallen from 6 in June to 4. That's not quite as low as it was in 2009 - the first time I ever had it tested, at 2 whopping ng/ml - when I actually was anemic. As my doctor told me earlier this week, my body seems to be really good at making red blood cells even when my iron is low.
What it seems to be really terrible at is absorbing & storing iron, especially when I'm training, even with supplementation. I don't get much from my diet to begin with, as a vegetarian, and non-heme iron (from plant sources) is poorly absorbed. Fortunately, I don't have the added depletion of monthly bleeding, as do many women with low iron - I can't even imagine how bad my iron status would be if I were bleeding every month.
There's increasing evidence that low iron affects athletic performance, training, and recovery, even when there's no anemia. In my case, running is harder, slower, and more fatiguing when my ferritin is <12 or 13 ng/ml, the bottom of the normal range - though it's never actually been measured any higher than this). So even though I'm enjoying my runs & workouts, they feel far more effortful than they should. Trail running is especially hard right now - steep uphill efforts are simply draining; if I push through the fatigue & keep going up, I get dizzy. Last Saturday's trail run at Cougar Mountain included unscheduled resting-against-a-tree intervals.
On Friday I'll see a hematologist to discuss my absorption & storage issues, and to ask for iron infusions - here's hoping he's receptive to the idea & doesn't want me to wait till I'm anemic again.
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