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The FAF AFAP Digest

Friday, March 4

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@ Gym:

RC work, 20 minutes

Stretching, 30 minutes


Swim/SCM/Solo:

1000 easy

hottub, 20 minutes

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Commentary:

Just taking it easy for the meet this weekend.


Iron in Athletes:

I started stressing about my thyroid levels earlier today. According to my recent labs, my levels of free T 3 and free T4 are worse in the last 6 weeks even though my thyroid medication was slightly increased. The only change has been adding iron to my regimen. Every doctor I've consulted seems to feel fairly strongly that my ferritin levels are simply too low. But I'm starting to wonder if the iron is preventing absorption of the thyroid hormones (a known side effect) while not helping much. Perhaps borderline anemia is my own norm? I've been that way all my life. Dr. Jimslie tends to dismiss diagnoses of anemia, saying that athletes suffer from pseudo-anemia. This is caused by a dilutional effect -- greater blood plasma volumes from training.

I decided to do some quick googling and found this article:

http://blog.firstendurance.com/2008/...ance-athletes/

One relevant excerpt:

"However, the most common cause of a low hematocrit (a ratio of red blood cells to whole blood) in athletes is pseudo-anemia, which is a dilution of the blood caused by plasma expansion. This is not true anemia, as the actual number of red blood cells is not decreased. (Portal 2003) Another study showed that endurance athletes were less likely than the general population to have iron deficiency. Out of 52 controls, 50% were iron deficient, and out of 126 atheletes, 26% were iron deficient. (Malczewska 2000)"

Another article and excerpt:

http://www.gssiweb.com/Article_Detai...?articleid=276

"But sports anemia is a misnomer because in most such athletes—especially men—the low hemoglobin level is a false anemia. The total volume of red cells in the body is normal, not low. Hemoglobin level is decreased because aerobic exercise expands the baseline plasma volume; this reduces the concentration of red cells, which contain the hemoglobin. In other words, the naturally lower hemoglobin level of an endurance athlete is a dilutional pseudoanemia."

Maybe my doctors just don't think I'm an athlete?

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Updated March 4th, 2011 at 06:50 PM by The Fortress

Categories
Swim Workouts , Yoga

Comments

  1. jim thornton's Avatar
    Leslie, ask yourself if you have the symptoms of clinical anemia. I just don't think you have these. If you were pathologically anemic, you would not have the energy to do the workouts you do.

    From one website:

    A person with anemia will feel tired and weak. That's because the body's tissues are not getting enough oxygen. In fact, fatigue is the main symptom of most types of anemia. The severity of the symptoms of anemia is in part related to how severe the anemia is. Mild anemia can occur without symptoms and may be detected only during a medical exam that includes a blood test.

    Symptoms of anemia include:

    Fatigue (Jim's note: this is different from sleepiness. It means you don't have the energy to get up off the couch. Fatigued people do not do SDK shooters, they just can't.)

    Weakness (Jim's note, or JN: you are stronger than me, and though I am a weakling as a man, I am low normal for a woman. Q.E.D. you are at least a normal woman.)

    Fainting (JN: you may occasionally suffer from the "vapours," but I have never seen you faint.)

    Breathlessness (JN: Only when watching Edward and Bella)

    Heart palpitations (rapid or irregular beating) (JN: I am sure if you start paying attention to your heart, you will find some examples of this, but I absolutely assure you that you are within normal limits!)

    Dizziness (JN: no more than anyone else)

    Headache (JN: ")

    Ringing in the ears (tinnitus) (JN: it's only the sound of teenage girls, not clinical tinnitus)

    Difficulty sleeping (JN: this is a universal human condition for anyone over 40)

    Difficulty concentrating (JN: ")

    Common signs include:

    Pale complexion (JN: especially pronounced in Caucasions during winter months in areas where there is significant cloud cover)

    The normally red lining of the mouth and eyelids fades in color (JN: You may no longer have Scarlett Johanson lips, but they seem prettily pinkish to this observer)

    Rapid heartbeat (tachycardia) (JN: dismissed earlier)

    Abnormal menstruation (either absence of periods or increased bleeding) (JN: I cannot really give an objective opinion here, but would refer you to Leviticus for a spiritual interpretation on the abomination-unto-God that the menses represents.)

    All in all, Leslie, I think your condition is what we fake doctors like to describe as "unremarkable," which is actually a good thing, because we tend to "remark" only on disorders.

    Real doctors, for the most part, would also describe your condition as robustly "unremarkable" too, save for the one difference, that is, between the MD and the MD (f): the former has a profit motive.

    Thus they will continue to titrate this, and palpate that, and adjust this, and conduct and trial of that, as long as your insurance company will pay.

    My advice: stop taking the iron, stop reading the tea leaves of these various T levels and ferritin scores, etc., the "normal limits" for which are established by "normal" American adults, who are fat and sedentary and not like you in many, many ways. Accept that people are often fatigued, especially when they do as much exercise as you do, and deal with as much perturbation on the home front with teenagers, college applications, a long distance marriage, etc.

    Give yourself a break, and join me at last in the ranks of the non-delusional hypochondriac swimming association of America!
  2. Bobinator's Avatar
    Hmmmmm. I just got results from my yearly checkup and my Dr. told me to start taking a vitamin with iron because I'm low. He didn't give me the exact numbers that I remember.
    It's hard to know what tired is. Should a person who works out seriously compare themselves to the general population? IDK?
  3. The Fortress's Avatar
    Quote Originally Posted by jim thornton

    Give yourself a break, and join me at last in the ranks of the non-delusional hypochondriac swimming association of America!
    Jimslie, I agree! I don't have any of the above conditions of anemia, except the universal human conditions. I am going to have a talk with the docs and only use iron when the nasty AF comes to visit.

    However, I do believe I have a thyroid problem because I have the classic conditions for that. For example, until the last couple years, I've never had a high LDL in my life and I've never had a core body temp almost 2 degrees lower than 98.6. Those are not good things no matter who you are. Won't bore you with other symptoms.

    My insurance company, unfortunately, loves to deny coverage for any reason, and does so frequently.
    Updated March 5th, 2011 at 10:14 AM by The Fortress
  4. The Fortress's Avatar
    Quote Originally Posted by Bobinator
    Hmmmmm. I just got results from my yearly checkup and my Dr. told me to start taking a vitamin with iron because I'm low. He didn't give me the exact numbers that I remember.
    It's hard to know what tired is. Should a person who works out seriously compare themselves to the general population? IDK?
    Good question! There is a difference between being tired from a busy life and not being able to lead one's life. And athletes often get different readings. One of my docs can't believe my HDL is 93 because he "exercises" too and his is 50 points lower. Mr. Fort also tests as anemic. Sometimes B12 is used to treat anemia. Much more tolerable than iron.
  5. aztimm's Avatar
    Maybe my doctors just don't think I'm an athlete?
    I think this is it. When I *only* swam, my doctor would sometimes just roll her eyes when I talked about working out. Once I started running, she seemed to take me somewhat seriously (more seriously after I told her I ran a marathon).

    Good luck in your meet!
  6. The Fortress's Avatar
    Well, they know I compete. I guess I'll lie and say I've been training for a marathon and see how that goes. Sheesh.
  7. jaadams1's Avatar
    Quote Originally Posted by aztimm
    I think this is it. When I *only* swam, my doctor would sometimes just roll her eyes when I talked about working out. Once I started running, she seemed to take me somewhat seriously (more seriously after I told her I ran a marathon).

    Good luck in your meet!
    My doctor knows that I swim, and at the competitive level, and encourages lap swimming for more patients too. She has many doctor friends who also swim for the health benefits it provides.
    Invite your doctor to go for a swim with you one day, and see how they do...
  8. The Fortress's Avatar
    Quote Originally Posted by jaadams1
    Invite your doctor to go for a swim with you one day, and see how they do...
    I may use this line next time.