High School Distance Runner Ferritin Levels Won't Go Up

further context- his ferritin was 32 at the end of cross country (the last time he had it tested before track)

He may not be taking it as consistently as he says

I had success with a one-time infusion. Raised my ferritin from 11 to high 80s -- steady now for three years.

Take ferrous sulfate with tiny bit of orange juice in the evening an before bedtime.

Make sure there is no calcium in the OJ and make sure it's several hours removed from any other calcium intake.

Also take B12 and folate, usually in the AM since B12 gives an energy boost.

Those ferritin #s aren't so low that it's anything alarming. Culprits of low ferritin in male runners could be sweat and on soft surfaces as much as possible to decrease footstrike hemolysis... especially for foot strikers vs heal strikers. This is literally when your foot strikes pound the red blood cells apart during foot contact..Running on soft surfaces is better than pounding pavement for this condition.

Don’t do this. It does not work at all. It taste like sh!t and proven not to work. It’s an old school way Joe Vigil spread around and will not work. Like 95% of the stores Vigil tells people. God bless him as he’s very old now. But his inflated stories are classic

Reach out to coaches that have spoken about ferritin levels and get the real answer on how to help.

Some people's bodies don't absorb iron/ferritin normally and need IV infusions to keep their levels up. Might be worth seeing a Hematologist.

I am also an old school fool, and I was a part of a program that was way more successful than Vigil's, yes THAT one. Our coach(yes, that guy) would send guys to the health clinic for actual shots of B-12 to help boost their iron absorption when their tests came back as being low. It was always diet related for the mileage we were doing. They would get chewed out, and then a shot. Anyway, to a man, their levels ALWAYS went up after these shots. If I remember correctly, it was a relatively short time that they saw an increase.

I found this:

"Both folate and vitamin B12 can cure and prevent megaloblastic anaemia. Riboflavin enhances the hematological response to iron, and its deficiency may account for a significant proportion of anaemia in many populations."

Take it or leave it.

Also, I have found that the very gross tasting, but more effective liquid supplements from plants sources, like "Floradix," which is actually a liquid Multivitamin, work very well to get the iron up, not that I am opposed to a juicy steak or burger, but the multi's cover's a lot of bases all at once.

Good Luck!

I’ve struggled with low ferritin my whole running career. I’ve had the best success with supplement. It’s very gentle and also includes vitamin c which helps absorption plus includes folate and b-12. Definitely reccomend trying it out. Good luck!

in case the link doesn’t work the product name is Nature’s plus Hema-plex. I get it on Amazon.

The coach's post below always sticks with me. Low ferritin can still mean solid workouts. And the ability to run 1-2 miles well. But then it all falls apart. My daughter went through this. Latter part of her XC season she suddenly lost her mojo. One race she reported that she was fine the initial mile, then her legs just got painful and stiff. We got her ferritin checked 10 days after XC ended, and it was 30. I'm guessing she was low 20's at its worst.

"The runner will tell me that on race day she breaks down at about 1 – 2 miles into a 3 mile race and just can’t get her legs moving. She reports that her training is going fine but on race day things go south."

runsub5.com

Fatigue 1 - 2 miles into your run - LOW FERRITIN

Janet Leet

I receive a lot of emails and phone calls about fatigue and racing. The runner will tell me that on race day she breaks down at about 1 – 2 miles into a 3 mile race and just can’t get her legs moving. She reports that her tra...

Link:www.runsub5.com/single-post/2015/10/01...

"Fatigue is a symptom – not a diagnosis. What the diagnosis is remains a mystery until all medical issues are addressed."

Smashing tons of iron is ineffective for raising iron.

Long text—kind of copy and pasting from various notes—let me know if I should clarify anything.

This is currently my preferred method for maintain iron levels:
250mg Lactoferrin daily (I use the Jarrows Formula from Amazon)
65mg Iron supplement every other day.
2000 IU Vitamin D daily.

There are various things that can interfere with iron absorption / use. One is the hormone Hepcidin. You can think of Hepcidin like a gatekeeper. It does not let new iron into your body, and keeps the iron you do have locked away. Taking daily iron also has been shown to increase hepcidin levels which is why various medical journals will now advocate for not supplementing with iron daily. This is also why it might be counter productive to simply double or triple your iron intake.
Hepcidin is not a bad thing because it is there to protect you from hemochromatosis or various bacteria/viruses using your iron to replicate. However, it can also work against you.

Vitamin D is known to decrease hepcidin levels. Decreasing hepcidin will allow you to absorb more iron and use what you do have. Not sure if you had your Vitamin D tested or if you current take it but if not you should consider it.
Vitamin D is fat soluble so it is recommended to be taken with some sort of fat. I take mine with heavy cream daily.
Second, lactoferrin helps with iron via two mechanisms. First it is antibacterial / viral. It can reduce unwanted gut bacteria which may be using the iron you ingest before you get a chance to. Second it binds to free iron extremely effectively, helping you absorb more. There are two different kinds of lactoferrin, one with and one without iron. Apolactoferrin is without iron which you need if you are trying to bind to the free iron in your system. This is what the Jarrows Formula is and why I use it. .

ncbi.nlm.nih.gov

The role of vitamin D in regulating the iron-hepcidin-ferroportin axis in monocytes

Chronic kidney disease affects 40% of adults aged 65 and older. Anemia of CKD is present in 30% of patients with CKD and is associated with increased cardiovascular risk, decreased quality of life, and increased mortality. He...

Link:www.ncbi.nlm.nih.gov/pmc/articles/PMC4...

ncbi.nlm.nih.gov

Comparative Effects between Oral Lactoferrin and Ferrous Sulfate Supplementation on Iron-Deficiency Anemia: A Comprehensive Review and Meta-Analysis of Clinical Trials

Ferrous sulfate is a commonly used iron supplement for the correction of iron-deficiency anemia but with frequent gastrointestinal side effects. Milk-derived iron-binding glycoprotein lactoferrin possesses well gastrointestin...

Link:www.ncbi.nlm.nih.gov/pmc/articles/PMC8...

Finally, actual iron. I use 65mg (325mg ferrous sulfate equivalent) every other day. I used to take it multiple times a day, but long term it doesn't seem to be any better than taking it sparingly because of the hepcidin issue from above. You could also try something like Hema-plex or another form of liquid iron. Iron is best absorbed in an acidic environment so people often take it with Vitamin C.

pubmed.ncbi.nlm.nih.gov

Iron absorption from supplements is greater with alternate day than with consecutive day dosing in iron-deficient anemic women - PubMed

In iron-depleted women without anemia, oral iron supplements induce an increase in serum hepcidin (SHep) that persists for 24 hours, decreasing iron absorption from supplements given later on the same or next day. Consequentl...

Link:pubmed.ncbi.nlm.nih.gov/31413088/

this is crazy. healthy athlete running good times being tested for iron? pfftt. setting aside the mileage is nuts.

and i say this as someone who was anemic my second year of XC. when that happened i was lethargic, slept all the time, felt like crap, ran slow and regressive times. that justifies intervention and testing. if you have a real issue it will communicate itself. otherwise, geez, be a kid and enjoy it.

to me if you're sick to your stomach it's too much iron at a time. not a fan of pills. i did egg yolk shakes.

My guess is he is overloading iron and unloading the nutrients that help protect his cells from oxidative stress And yes there is a leak of sorts.

Of course the D should be checked as well but that would be more likely low if he were having breathing issues and paler skin.