Junior girl in HS Struggling, please help

Most doctors don't really seem to understand the importance of good iron levels for runners. I've found when Im at the low end of "normal," as a runner thats not enough. What is the height and weight of this athlete? How many miles a week does she train? Is there an ED suspected or is she just runner thin?

Two years ago we were a little worried about her eating. My wife (has experience with ED) and her mom spoke with her, she responded well, put on some weight and has been fine.

Not sure of her height and weight, little and thin but not unhealthy looking. Runs around 35-40mpw.

Anyone have insight as to why she didn’t have her period and why it came back after 1.5yrs. How would this effect running?

Lots of things going on here. I am not a medical professional but not having her period for a year and a half is a serious issue as is her low iron level. Getting her diet, vitamin levels, and body fat percentage to a healthy level is more important than her running.

She definitely needs to see medical professionals or even counseling if she has an eating disorder/body image issues. Amenorrhea is commonly a sign of low body weight and excessive exercise and even a side effect of an eating disorder or her low iron levels.

Liquid iron supplement will certainly help a lot. Most doctors do not understand distance running and the importance of high iron levels. If she is on the "border" according to the doctor than she should be taking iron supplements everyday, especially if she doesn't eat enough.

Read up on central fatigue.

Undertrain.

Check for sprint capability.

Runner12345678 wrote:

If she is on the "border" according to the doctor than she should be taking iron supplements everyday, especially if she doesn't eat enough.

I agree here: "lowest normal" is completely inadequate for endurance athletes. The amenorrhea also has to be addressed; the irony is, now that her period has resumed (but is it regular?), she's going to be losing even more blood/iron.

It's not really intuitive, but I've found that serious strength work helps in this situation, at least with some. (By "serious" I mean a whole-body routine, particularly including the legs; and not an endless-reps-at-baby-weights deal, but more like working up to a classic three sets of ten routine with challenging weights, two or three nonconsecutive days per week.) It may be best to do this at the start of her workout, in lieu of some of the running that her teammates are doing: She gets to "earn" the running part of her workout by lifting (and logging the lifts).

The running parts of her training can be tough to set up, because essentially she's running at altitude. On distance runs, she may be better taking walking breaks, so that when she *is* running it's at something like a normal speed for her. (Avoid the slog-and-jog, last-it-out kind of running--that won't help her.) On faster work, she may be best served by doing only *one* fast piece, rather than multiple repetitions. And her total mileage will be lower, as it would be if she moved to altitude.

Please bump this thread periodically and keep us updated on her situation. Good luck to you both.

Pics?

It seems like if she was as low as you could go without being anemic, then her ferritin is probably really low. Get that checked. If she doesn't want to go to the doctor again, you can get it checked for under $40 with private med labs or someone else.

she should definitely ask the doctor for the numbers on the iron because sometimes they just tell you its normal and dont even give you the numbers. Let us know if you find out.

Get the iron, hemoglobin and ferritin numbers.

It sounds like she is really low. Iron supplementation should begin immediately. Take it with OJ.

Take a multi-vitamin with a meal (fat solubles don't absorb without food.)

Consider getting a B-12 shot.

Of course, you need to tell the athlete and parent to ask about these things and then the doctor can agree to do them.

You just said her iron levels are as low as can be without technically being defined as anemic. You also said that she did not have a period for the last 1.5 years, which would indicate that she was probably not eating enough for her activity level. It seems obvious to me why this girl feels like she has no energy. 1. low iron, 2. wasn't eating enough for a long time, 3. her body seems to be rebuilding as she just got her period back. I think it would be a good idea to let her stay on the team for social reasons and maybe just do half the training as everyone else or just warmups for a season. It doesn't hurt to be cautious at this point because pushing it when unhealthy can have ramifications for life. Discuss with her parents how comfortable they are with certain levels of training and competing. A decision needs to come from all sides, be conclusive, etc. and she needs to understand that you have her best interests at heart and are not the enemy (trust, authority figure).

'her Doctor said she was as low as you could be without being anemic. So he said she's okay.'

Bit of a contradiction! She needs treatment go to a different Doc

Hi Coach OA,

It is a really good thing as a coach that you are looking into this and concerned for this athletes health. One of the things girls of this age and even in college do not understand is that lack of menses can inhibit proper bone development/density, and has been shown to contribute to osteoporosis. Many ppl have written in about this athlete not taking in enough calories. Having ammenorrhea is the body's way of conserving energy (her body is likely prioritizing what the most important things are to expend energy on). In my opinion 35-40miles a week is pretty hefty for a junior in high school (I'm assuming she is training for 5k's)? If there are no other indicators of why menses has stopped (hormonal/problems w/repro organs) she needs to consume more calories. I think girls of this age and even in college are concerned of gaining weight/being slow and begin to restrict food. If she is expending 35-40miles worth of energy she needs to eat especially at a critical age of development.

One more thing... she may have over trained prior and started menstruation because of not training as much "only running 20 min until feeling dead". This goes hand in hand with not consuming adequate cal's. Some ppl say they can "eat their way out of over training" when symptoms first start. Once the wall is hit however, the body just needs to run it's course...Next time consuming enough cal's to meet energy demands should prevent this! Assuming this is the prob.

A couple of comments from a mom with a small successful distance runner. See if you can get her to a nutritionist. IT is ABSOLUTELY critical that it be a nutritionist who understands distance runners. When female distance runners are performing/training with effective efficient training their nutrition needs are different than an average extremely active teenager. Many medical professionals do not understand this. What she eats is as important as how much she eats. Also, no one has mentioned WHEN she eats. Making sure that she gets fuel 45 minutes to an hour before she begins training will help ensure she does not run short during effort. Also very critical to recovery is fuel including some form of protein not more than an hour after effort. This will help prevent going into deficit. The point is to build muscle and strength not to have the body constantly struggle to maintain.

Hydrate, hydrate, hydrate! Good luck.

Wow, that sounds exactly like my junior year of high school. I ran 5:08 and 11:16 as a sophomore and was barely breaking 5:20 as a junior. I also did not gain weight, but lost weight in fact. I went on this "calorie counting---I have to be as thin as the girls winning the races" kick, and went from 108 pounds to 98 pounds on my 5'4 frame. I completely gave up red meat, because I thought it was a "bad" food. Of course, I lost my period and voiced concern to the doctor. The doctor then says the worst thing that you could ever say to a teenage girl, "Well, your body fat seems high enough." The doctor ordered a CBC (with no ferritin count) and my hemoglobin was at the lowest end of normal. Even though the doctor told me otherwise, I knew I wasn't running on all eight cylinders. That was kind of a rock bottom point for me in high school. I started to eat normally again (with red meat) and ran a 4:46 1500 meter in June of that year, despite being 10 pounds heavier. I went on to run 10:53 and 5:03 my senior year and ran on scholarship all throughout college. Bottom line: Restrictive eating can ruin your career (it almost ruined mine).

Came back from the trenches, did you get help from someone? Who taught you how to eat right?

Her times are about the same as yours too, any other advice you have would be appreciated.

Thanks everyone I’m grateful for all the informative responses.