#or like do let me know if i am at the low end for ferritin after complaining about fatigue
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i've had to get regular blood tests for the last year for ~*~ chronic illness ~*~ reasons, which sucks because a. hassle and b. chronic illness, however the one upside of this, as a data nerd, is that my online patient portal shows me graphs of different blood measures
gotta get enrichment for my inner data scientist each time i go to a&e
got very normal blood, the most normal blood, got it tripled checked by doctors for my normal blood
#loaf to void#real talk tho#most of my blood tests are within normal ranges and my symptoms are quite variable day on day#so like for the few blood tests that do show a worsening trend its really useful for me to look back on them and be like yeah i really am i#and also to track: oh yeah this matches with this flare i was having#or holy shit how were they not noticing that that drug was definitely causing liver damage (my baseline was very low for that measure)#like i know the nhs doesnt have time to be personalised in its care#but THE TREND IS PRETTY OBVIOUS#or like do let me know if i am at the low end for ferritin after complaining about fatigue#wait i just googled the range and technically i should have been considered anemic
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All the Cliches
When I started writing this post in my head, I was going to title it something like Out of Hibernation, yet make it known that I wasn’t planning to bore you with a 1,300 word soliloquy comparing myself to a Bleeding Heart (which is apparently a Spring perennial and, you know, we’re all about cliches here) blooming through the last remnants of Winter frost.
Then I thought, no, do I really need an intro to tell everyone I’m back on my bullshit after a few steps forward and another step back?
Then I realized...isn’t running really just the epitome of a giant cliche?
TL;DR I had a big accomplishment in the fall and thought the momentum would carry over super easily into the Spring. I ignored some symptoms, realized I was anemic, felt really sad, and now I’m starting to feel like myself again. aka, the simple, common, cliched journey of every.single.runner.
Even though this experience is the embodiment of what it means to be an endurance athlete, why do we act surprised every single time? Leading up to Philadelphia, after my year of mystery illness [which, it turns out, had another plot twist. Remember how I was having a massive immune system reaction and pretty terrible quality of life? Well, after we found mold in the house the problem went 90% away. The remaining 10% was still driving me crazy. Long story short, the installation of a whole-home water filter has returned me to a fully functioning human being. Hello, my name is Anna and I’m just your local canary in the coal mine] I vowed I would do a better job about just letting life go with the flow and not try to fight the current every step of the way. I guess I got too big for my britches because - lo and behold - I found myself avoiding what I pretty much knew all along.
After Philadelphia, I took 2 weeks off and really enjoyed my down time. The highlight was a day trip to French Lick, where Dave and I hit the casino (I won $25), ate all the sweets, shopped, split an amazing kobe beef burger, got day drunk, and took the scenic drive home. The next day I started running again and, much to my surprise, felt way better than I normally do after two weeks of zero exercise. This felt like a big win.

December turned out to be extra crazy, then at the end of January I co-hosted a women’s running retreat, BAnna Camp. Any fatigue I was feeling during December and January I just chalked up to stress and the typical things you do when you’re in that awkward in-between period from one race to another: less sleep, less healthy food, less fitness.

^have to make sure this post never dies
The first day I was in Austin, Becki and I did a workout together. It was my first “real” workout back (other than some fartleks and strides), and it wasn’t even supposed to be hard: 3 x 7 min @ 6:00 pace. I STRUGGLED. I couldn’t breathe, my quads were heavy, and the paces felt much more difficult than they seemed like they should. But, there were plenty of excuses: it’s windy, we were running a net uphill, I was dehydrated from travel, I was stressed about the upcoming camp, etc. etc. Midway through that workout I had a very distinct thought of oh shit, this feels very anemic right now. That night I texted my friend who would be joining us later in the week and asked her to bring some iron pills, since I had forgotten my supplement.
The following week my workout didn’t feel great, but again, it was easy to make excuses. I was on a treadmill. I was still catching up on sleep from camp. Maybe I’m more out of shape than I thought.
Longer efforts didn’t feel great, but I was getting them done. My paces felt quick, but, winter training never feels amazing. Plus, it seemed like every workout I did was into a strong wind, so how can you really judge pace and effort?
In early February, I had my first race of the season which was a 5 miler in downtown Indy. I had told Dave I was going to hold 5:30 pace for as long as I could and see what happened. My first mile was 5:54, and Dave said he could hear me breathing before he could see me. I was 3rd that day in just under 30:00. Again, there were plenty of excuses. It was windy. We had celebrated Valentine’s Day the night before, so maybe steak, lobster, buttered mashed potatoes, and wine wasn’t the best pre-race meal?
During my sulking about the race I had an aha moment. In December, prior to realizing we had an issue with our water, I was trying to figure out what was still causing skin rashes and GI issues. The only thing I was taking every day was ferrous sulfate, which is an iron supplement that is gentle on your stomach but has some suspect ingredients (food colorings, sorbate, etc.). I decided to switch my supplement (one that had worked for me for YEARS) to something that seemed “cleaner”: ionic iron. While I was wracking my brain trying to figure out what could be wrong, it occurred to me to check my iron dosage.
I was taking ~10% of my normal ferrous sulfate dosage, and honestly don’t even know how absorbable ionic iron even is. That day I made the switch back to ferrous sulfate, but knew that if my iron/ferritin was low, it would take about 6 weeks before I felt a difference.
If at this point you’re reading along and thinking to yourself, it’s not expensive to just go and get a blood test to find out whether your iron is low - you are absolutely correct. I should have just scheduled an appointment to take a blood test and find out. But, I’m stubborn.
Two weeks after my 5 mile race I flew to Atlanta for the Road to Gold, an 8 mile race on the 2020 Olympic Trials course. This is a whole other post in and of itself, but I will say that the hype is real. That course is going to be hard.
While the experience was great, my time was not. My goal had been to run 5:45 pace through the first 4 miles and then pick up the pace. While I did go through the first 4 miles in 22:50, just under my goal, I went through the next 4 miles in 24:20ish, and again felt as though I couldn’t breathe. I finally conceded it was time for a blood test.

The results were pretty much exactly what I thought they would be: low ferritin, high CO2 in my blood, and borderline-low Vitamin D. After weeks of agonizing over whether I was out of shape I finally had an answer (albeit one I should have just figured out sooner). So, I upped my iron supplement and looked ahead.
Nowhere to go but up, right?
In the following weeks I paid better attention to meal timing (i.e., if I was having a steak for dinner I wasn’t pairing it with red wine or other iron-inhibiting foods). I cut out my second cup of coffee in the afternoon so that my body could have a better chance at iron absorption. I focused more on sleep. I got back on nutrient tracking to make sure I was getting everything I needed from my diet.
and it paid off
6 weeks after my miserable 5 mile race where I could barely run faster than 5:58 pace for 5 miles, I ran 1:16:37 in the Carmel half marathon on a less-than-ideal day with rain and wind.
During race week I cut out all caffeine and red wine to hopefully give my body the extra boost it needed to absorb iron. I meal prepped early in the week so that I had nutrient-rich options readily available. I said no to a couple work-related opportunities that popped up in favor of less stress, and I gave myself my best chance to succeed.
In truth, sometimes setting yourself up for success is scary. What if you do everything possible and you don’t succeed? I have seen so many talented athletes give up because they went all in and it didn’t immediately pay off. But, that’s probably another post for another day, too.
Come race day we had 15 mph winds, pouring rain, and puddles on the course. It will sound sarcastic when I say this, but that truly is my favorite racing weather. Going into the race my A goal (not accounting for weather) was 75 min, B goal 76 min, and C goal 77 min. My plan was to run the first 10 at 5:45 effort, then see how fast I could go the last 5k.
Starting off, I was very pleased to find myself in a pack of men and through the first mile around 5:40. I NEVER trust my GPS, so all splits I give will be those from the course. I went through 4 miles in 22:50 - the exact same time I went through 4 miles in Atlanta, only this time I felt so much better. I went through 6.55 (again, as marked on the course, not my GPS) in 37:26 and felt like I really had a chance at sub 75 still. Through 10 miles I was right at 58 min. I felt strong for the first time in a long time.

Around mile 11 I started to get tired, and just focused on getting through 0.5 miles at a time. T last couple miles were definitely the toughest, as they were mostly uphill/into the wind. 76:38 is my fourth fastest half [74:03, Houston, PERFECT weather; 75:20, ‘17 US championships, goal race full taper, 75:59, Columbus half, 4 weeks out from Philly], and this gives me a lot of encouragement considering some sub-par months of training.
Now that I am feeling the effects of higher ferritin, I’m beginning to wonder if I wasn’t a little bit low during my Philly build up. I have had some of my best long runs and workouts the past couple weeks - ones that would have blown away what I did leading up to Philly. It also makes sense, given how I felt the last half of my Philly race, that my ferritin may have been low. Moving forward, I’m going to schedule blood work much more regularly so that I don’t have preventable problems like this occur. Definitely kicking myself, but, as with all failures in life it was a great opportunity to learn and grow.
My next race is in 6 weeks and I’ll be at the 25k championships in Grand Rapids. I’m looking forward to seeing what another 6 weeks of quality training and (hopefully) warmer weather can do for my fitness!
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Why I Won’t be Running CIM
I should have known this training cycle was doomed when my first week of training was sidelined due to serving on the jury of a murder trial.
Yesterday I had the difficult task (one that reminded me all too much of college) of contacting all involved in my running or upcoming races and let them know that my coach and I have decided to pull the plug on the rest of the season. No Monumental half, no CIM.
How did I get here?
Six weeks ago I ordered a blood test to confirm my suspicions that something was up with me, biochemically. I suspected ferritin to be the culprit, and in addition I also had low iron, vitamin D, potassium, magnesium, and folate. My telltale symptoms included persistent quad soreness, irritability, uncharacteristic sadness, extreme fatigue, and difficulty sustaining longer efforts, like tempos and long runs.
I received my blood test results ~10 weeks out from CIM, so I was confident I would be able to raise my nutrient levels and return to my normal self in time. Two weeks later I was feeling a lot better. Sure, I was still sleeping 12 - 14 hours per day and needed a caffeine drip in order to get through daily tasks, but I was determined to feel better.
I was extremely pleased with my performance at the Ft. Ben half and thought it was a sign that things were improving.
But, the following week things took a turn for the worst. I was suddenly feeling like I was back at square one, and the 90 miles I ran the week before were followed by a 56 mile week, because that was all I could muster. I attempted 5 x 2 miles at marathon effort 7 days after the half marathon and could only manage 7:00 pace. Clearly, I had taken a couple steps backward.
My coach’s solution was perfect: take a week of no workouts, no watch, no expectations. Only run on trails. If I needed a day off, take a day or two off.
After that week, I felt refreshed. I made it through a 19 mile run on Saturday of that week (my longest in a while), but, my quads were on fire for the final 6 miles. The next day, though, I felt great. Springy, even!
Then the cycle began again. Monday felt okay, Tuesday was a decent, albeit short, workout, and then the wheels fell off. Thursday I set out to repeat a workout I had done 8 weeks prior: an 8 mile tempo at marathon effort. I repeated the same route, and had better weather this time. The first tempo was completed right before I found out my ferritin was low, and I averaged 6:03 pace. This would be a great test to see how much I had improved.
My splits: 6;03, 6:06, 6:09, 6:17, 6:19, 6:15. Then I stopped. The effort I had just put forth on a downhill section running with the wind to split 6:15 was far greater than marathon effort. My quads were completely locked. To keep going wasn’t going to get me anywhere.
But, bad workouts happen. It’s when bad days stack that you really have to worry, right?
The next morning, I woke up and had no desire to run, a feeling that has become commonplace lately. But, I was meeting a friend for a standing run date we have every Friday at 9 AM, and company always pulls me out of a funk. Except, this time it didn’t. We got 2 miles into the run and I asked her if we could stop. My heart was pounding (I made her feel my pulse to confirm I wasn’t crazy) and then I started crying. I was so tired of feeling like crap. The thought of finishing that run (only 6 more miles) sounded absolutely terrible. My running partner has also struggled with low iron, so she was very sympathetic to how I was feeling. We walked / jogged back to the cars and she listened to me as I ugly cried about how tired I am of feeling this way. I texted my coach and we decided to see how the weekend went before making any calls.
Saturday was another bad day, so we decided it was time to stop and recover. If I kept going like this, I was going to dig myself an unnecessarily deep hole. My concern? If I kept training like this I would finish CIM and never want to train for a marathon again.
To be honest, deciding to stop and take a break has made me feel relieved, as opposed to sad. In my own coaching, when someone questions whether or not to pull out of a race, I ask him or her, “If the race was cancelled and you were not able to compete, would you be relieved or pissed?” If relieved, that is usually a sign that you shouldn’t run.
I am a competitor and train to compete. Yet, I would have been so relieved for the race to have been canceled and to focus on a new one. I should have asked myself that question a long time ago. When I was texting with my coach about ending the season, Dave and I happened to be at a bar with the dogs. Afterwards we went out for an amazing dinner at Capital Grille. According to Dave, choosing to end the season early resulted in a more relaxed me than he had seen since before we got engaged in May. I will admit that this training cycle has weighed heavily on me.
What other signs did I miss that I should have reconsidered CIM?
I had started to plan my runs based on the fact that I might not finish them. Instead of running long loops like I normally do, I was planning routes that went by my car frequently. Lately, I have had a lot of days where my runs get cut short.
I have been overly reliant on caffeine. In a typical week, I only drink coffee once or twice, usually as a post-long run reward. For the past 6 weeks I have had coffee every single day, solely to help me get through my run (even easy days).
I have been sleeping an obscene amount. In addition to 9 - 11 hours per night, I have been taking 2 - 3 hour naps.
Talking about running has mostly made me irritable and angry. I become frustrated when people ask me how my training is going, or tell me that I still have time to feel better. I had to ask Dave to stop asking me how my runs / workouts went.
Probably the worst is that running just hasn’t been fun. Instead of worrying about whether or not I will hit my splits, I have gone into runs not sure if I will be able to finish. A common tip that I give to my athletes is to use the “10 minute rule” when motivation is low. If you get 10 minutes into a run, 99% of the time you will keep going. For me, more often than not I was getting 10 minutes into runs and wanting to stop.
I was also putting a lot of energy into trying to make this work. I have a notebook filled with lists I made of how to get through the next 6 weeks; how to control the controllables; how to feel better when workouts were bad, mantras, etc. While those are all great tactics, I should have realized that relying on them to that extreme was out of character for me.
Of course, I have second guessed whether I made the right decision. On Monday I woke up and thought to myself, “you know what? I was too hasty, I’m going to get up and go for a run and see how I feel.” I immediately jacked my knee getting out of bed and was limping around the rest of the day. I”m chalking that one up to the universe telling me to stick with my plan of no running for a couple weeks.
I know that I am going to be sad when I spectate Monumental and during CIM weekend. I will probably compare myself to other people in the race and try to convince myself that I could have placed highly, like I did after the 10 mile. I will probably be a little salty those weekends. But, that isn’t necessarily a bad thing. One thing I have lost these last couple months is my characteristic fire and feistiness. Is it really that terrible to get a little jealous and fired up?
I’m waiting on the results from a second blood test, but my gut feeling is that my ferritin has either not budged, or possibly even dropped. My guess is that I wasn’t able to rebuild stores while continuing at a high level of training, and probably that I wasn’t responding to the supplement I was taking (iron bisglycinate). I have switched to liquid iron, and am hoping that some total rest will make me feel better. Hopefully I will be ready to go for a Spring marathon.
I’m super thankful for everyone who has listened to me or helped me out the last couple months, including my coach, my mental game coach, my nutritionist, oiselle (shout out to Dr. Lesko!), my massage therapist, Dave, and Becki and Andie (my go-tos when I’m not feeling great). Fortunately I think I’ll live to fight another day!
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Plot Twist!
Ever since I read Devon Yanko’s blog post after Leadville, yelling “plot twist!” during less-than-ideal situations has become my new favorite thing.
My expectations for summer and fall training were that I would run hyper-high mileage, never miss a single workout, feel amazing every single day, and then arrive to the starting line fitter, stronger, and healthier than ever before.
Of course, when my life is made into a Disney movie, that story line is going to be pretty boring, isn’t it?
This summer as a whole hasn’t felt amazing. But, who can expect it to be when the past 8 weeks have been soupy and swampy, and the previous 6 weeks were spent planning an impromptu wedding?
I think my first indication that something was “off” should have been MI bird camp, when my legs didn’t recover for a full 5 days after my long run. No worries, I thought - it was extra hilly and I probably just wasn’t acclimated to running steep downhills.
I was frustrated with myself for taking so many days off over the summer. I felt like I needed one per week, which is a departure from my typical one-day-off-every-6-weeks. But, I figured that was the price I was paying for running 90 - 100 mpw in hot and humid weather, when normally my mileage is only that high in the fall and winter.
As time went on, I was a little bit concerned about how I lacked motivation to get out the door. Dave pointed out that I am someone who usually races often, and this long period of just training was probably starting to get to me. Fair enough.
Then, I started noticing how unhappy I was in my day to day life. Suddenly, nothing seemed to make me happy. I wasn’t getting any enjoyment out of my favorite things, like a good cup of coffee, journaling, playing with my dogs, cooking, binge watching favorite episodes with Dave and a drink...and that worried me.
Finally, I realized my motivation to run was becoming completely nonexistent. However, one running partner moved away, another is injured, and Dave has been out of town a lot so I kind of chalked that up to having to do a lot more by myself. I thought I was becoming bored of my running routes. But, then I had a week of running where even if I did get out the door, I would get 10 - 20 minutes in and have no desire to keep going. For me, that is usually the key signal that something biochemical is amiss.
The weird thing was that workouts didn’t completely suck. For instance, 3 weeks ago I did an 8 mile tempo on a warm and windy day in 48:27, which I was very happy with. However, 2 days later I struggled through a cruise interval workout.
The following week I did 12 x hill repeats and felt AMAZING. But, I did a 14 mile progression run two days after that where I couldn’t hit 6:00 pace at the end to save my life. I texted Becki Spellman and tried to get her to agree with me that a 14 mile progression run ending at 6:00 pace is much harder than an 8 mile tempo at 6:00 pace, but I’m pretty sure she thought I was crazy. My coach’s solution made sense: I just needed an extra day of recovery until my body acclimated to the mileage.
Last week, I went out for 8 x mile at marathon effort. I tried the workout on Tuesday, but went home after the first mile of my warm up. The next day I tried again and the heat / humidity / dew point reached their summer peak. I wasn’t surprised that my last mile in 5:38 equated to a heart rate of 186. But, at the same time, I’m used to my workouts having a certain je ne sais quoi about them. Even when conditions are tough, I usually find a way to surprise myself.
Here I was, though, the queen of high mileage not enjoying training, life, or really anything in between. Everyone’s solutions made sense: the heat, the humidity, post-wedding let down, higher mileage, less racing, etc. Deep down, though, I think I knew there was more at play. I mean, there had to be, right? How does someone go from talking about the vibrations she feels when she drinks a good cup of coffee to crying through her morning routine? Oh yeah, and there was the fact I was suddenly sleeping 10 - 14 hours per day.
So, I ordered a blood test. Now, in reality I should have done this sooner but 1) they are expensive, and 2) did I really want to know? There was a small part of me that was terrified nothing was wrong. Afterwards, my coach chided me a little bit for not speaking up about how I was feeling earlier. But, there were so many logical reasons for why I was feeling that way, and I was also worried I just wasn’t being mentally tough. What if nothing was wrong with me?
Fortunately, Dr. Lesko [oiselle elite team manager] had recently recommended Athlete Blood Test to the Haute Volee. I’m sure I will be asked how I chose this specifc test versus Inside Tracker, and the truth is that ABT tested what I wanted [specifically ferritin and cortisol] at the best price. I did the bronze panel and paid a little extra to test my Vitamin D levels as well.
Before I received the results I was convinced my ferritin was low, my coach assumed potassium was the problem, and my pharmacist friend was certain my folate levels were to blame. Surprise! It was all 3! Plus magnesium, iron, and Vitamin D.
Fortunately, none of my levels are dangerously low. Aside from folate, all are low for an athlete, but not out of range for the general population. The reason that I chose to have my blood tested by an athlete-specific testing company is that the distinction between athlete and general population is made. For instance, my Vitamin D levels were 43. For an athlete, they should be above 50 (ideally closer to 100); but for the general population they should be above 30. Sometimes doctors take for granted that athletes have different needs, and athlete blood test gave me ideal ranges based on my age, sex, and hours / intensity that I spend training.
While most of my levels were athlete-low, my folate was low for both an athlete and the general population. Here is something that I did not know: low folate can manifest with similar anemia-like symptoms as low ferritin. Once I got my report and began reading how my different “slightly low” and “low” levels affect the body, everything began to make complete sense.
The blood test wasn’t without some good news. One measurement that Athlete Blood Test makes is training tolerance. They run a comprehensive metabolic panel and also test cortisol and inflammation markers. Despite running 90 - 100 mpw in the worst conditions of my life (seriously, this summer has been worse than the one I spent in Baton Rouge!) and feeling a little down while doing so, I received the highest score possible in recoverability.
All in all, I think it’s pretty positive! I’m meeting with my nutritionist tomorrow to talk more, and also supplementing the areas where I’m low. I think I underestimated the toll that the heat was taking on me, and not respecting the fact that the humidity kills my appetite. I probably wasn’t doing the best job fully refueling, since it was easier to grab a packaged meal than cook an elaborate dinner. I was more concerned about calories and macronutrients than the entire nutrient spectrum.
Most of all, I am excited that regardless of the poor micronutrient score, I have been able to run more mileage and higher quality workouts than I was 2 years ago. I did decide to drop the 10 mile championships from my schedule (they are on Sunday), because killing myself on a tough course and further depleting my body isn’t in the best interest of my ultimate goal, which I shared earlier this week. If I get through this training cycle and the worst thing that happened was a 60 mile week last week because I chose to listen to my body instead of force myself to run when I wasn’t feeling 100%, I’ll call that a major win! All in all, I should be back to normal within 3 - 4 weeks, and I can’t wait to see how I feel!
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