Advice Needed On Blood Test

I've been taking blood tests all my life and I always get a B+.

No Ferritin score? That is what I have always had checked to see if I am anemic.

You're just below the range. Do you eat meat? Up the lean red meat or eat some liver.

I'm assuming you're male. If you're female your measurements are fine.

For a healthy young guy you are pretty anemic - certainly enough to significantly impact your performance. A lot of doctors might blow it off but you need a full work up - complete blood count w differential, peripheral smear, vitamin b12, ferritin, ect... Most likely you are iron deficient. I would recommend IV iron and definitely increase Fe in your diet- but need confirmatory tests. Eat iron rich foods, most oral supplements aren't absorbed well. Could be caused by your higher miles and increased turnover of rbcs and not enough iron in diet to keep up, but blood loss should also be ruled out

I'm a doctor btw

I had almost those same exact numbers a few weeks ago, with 16.0 and 48ish being my baseline. It turned out I had hemolytic anemia, most likely from taking off a few weeks, putting on eight pounds and hammering the concrete again.

Like others have said, if you had a full iron panel, it would tell you more and if other things lead you towards foot strike hemolysis, you should get a peripheral blood smear.

What was your MCV/RDW?

After six weeks, I went from 12.7 to 14.6 and supposedly it resolves on its own.

Maybe you can work on running more on softer surface as a precaution until you get it figured out.

desire an A once-in-awhile wrote:

I've been taking blood tests all my life and I always get a B+.

Ha, I get an A+

You have AIDs

you're fine. Seriously.

As a doctor one thing you always learn is look at the patient, not the labs. First, you aren't too far off from the normal range. I would be ecstatic to see those numbers on my patients, but that said they aren't trying to be competitive runners. Ferretin, and RBC morphology can be helpful to diagnose iron deficiency v. anemia of chronic disease. If you;re really worried, check this out. But I seriously wouldnt worry.

All - I am getting a second blood test that covers ferritin, b12, folate, etc.

blaznbison24 - My MCV is 90 and RDW is 12.9, which puts me in the middle on both of those categories.

I did take some time off back in early June, maybe put on 5lbs, and then got after it again. Why would cause one to be hemolytic anemic?

Also, I'm not injury prone at all so is your suggestion to run on softer surfaces to help avoid injury while I'm figuring out what's going on OR does it have something to with my red blood count? Excuse my ignorance.

Liver Lover - Yes, I'm male. I do eat meat, but not a lot of red meat. I generally eat healthy and should be able to maintain iron levels without having to eat read meat much at all.

BJB Thanks for you comments. My doctor is concerned and is having me come back in next week for a second blood test. Testing ferritin, B12, folate, gluten, etc. I'll post the results here.

Quick question -- if I've started to eat a lot of iron rich foods and taking a supplement, then come test time next week, are my iron levels going to be elevated to the point where it doesn't look like anything is wrong (if i did have low ferritin to begin with)? OR does it take significant time to raise your iron levels? Thanks!

We've also discussed the possibility of an absorption issue as I have other indication that that could be the case.

okerson The only reason I'm worried is because I train my ass off to compete and it seems to me I'm currently operating at a significant disadvantage. I want to figure out what's wrong so that I'm ready to go on race day.

OP's GF here. Get off LR so we can go camping.

Ferritin? wrote:

No Ferritin score? That is what I have always had checked to see if I am anemic.

Why? A ferritin level doesn't tell you if you're anemic. A hemoglobin/hematocrit does. Do you even know what "anemic" means?

Ferritin just helps you decide WHY you might be anemic, but you have to find out first if you actually ARE anemic.

Bump. I'm having similar issues...

Hiya folks wrote:

Ferritin? wrote:

No Ferritin score? That is what I have always had checked to see if I am anemic.

Why? A ferritin level doesn't tell you if you're anemic. A hemoglobin/hematocrit does. Do you even know what "anemic" means?

Ferritin just helps you decide WHY you might be anemic, but you have to find out first if you actually ARE anemic.

Hematocrit does not tell if you are anemic or not either. Maybe you need to learn what anemic means and how it is diagnosed.

RANT:

You guys are misleading yourselves. I come onto this site daily and see someone freaking out about totally normal range (yes even for runners) blood tests, on a wild goose chase to change something outside of their control. It is completely normal to be fatigued with training. You were completely at baseline until you got a (for you) sub-optimal H&H.

To boot, many of you put on that you know a good deal about hematology, but seem to not even have the basics down. Reading a wiki page and being a physiology major does not count. Many of your proposals to optimize baseline lab work will only serve to disrupt a well balanced homeostasis and frustrate you. Outside of altitude chambers and EPOR agonists you aren't going to increase your h&h. Eating iron won't stimulate RBC production. Iron is toxic in high concentrations, and bacteria LOVE it which is why the body sequesters it in chronic disease/infection. Your MCV is normal, you do not need to check B12. Thats absurd. it remains stored in your liver for like 3 years before it would be depleted enough to cause pernicious anemia anyway, folate is more or less the same.

Just keep running, rest well, eat well, and you'll run fast. Simple as that. Stop the psuedoscience witch hunts, get out of your head, and train smart.