Slow and Steady

As is normal for me, I’ve gone and pushed my limits again. Not that I’ve done anything crazy, nope rather simply training and riding my bike. After a heavy two week block it has become obvious that I cannot right now put together two hard/long back-to-back days. This is frustrating. This is not where I want to be right now. But it is what it is.

This state of affairs has nothing to do with my training regime or lack of desire. Nope – if only it were that simple. Rather this is the result of my body. I’ve had to admit that it is just not ready yet. I’m just not ready yet. I keep telling myself that I’m healthy and that I am “normal”. Well, as it turns out, I’m not. My ulcerative colitis symptoms are not around but I’m suffering from the impact of getting so sick in December. I’m at a point now where my medicine is keeping me in a remission but I simply cannot get my ferritin (iron) levels at a normal level.

A ferritin level of 11 is not normal. I should be at around 100. I’ve tried to do all I can with this measly number of 11, but it really isn’t taking me very far. So now I’ve had to admit that this is where I’m at. And figure out how to deal with it.

Thanks to some words of wisdom from Marc, I’ve been forced to admit that I’m not healthy – I’m still sick. I need to get healthy and then I can do what I want. This doesn’t mean I’m not training. It just means that my training is different. No hard back-to-back days. No more really long rides. If I’m tired, I don’t ride. And the hardest part of all – to not berate myself when I don’t ride or I have to cut a ride short.

I’m still focused on my goal of racing at the 2012 World Cyclo-Cross Championships in Koksijde, Belgium – but now I’ve got another goal I have to accomplish first – get healthy. So this is where I’m at. As much as I’d like this to be an instant gratification goal – I realize that in this case and is often the case with most goals worth attaining, slow and steady is the only approach.

(If you have any suggestions on how I can get my ferritin levels up to  a normal level, let me know. As it is, I can’t take any over-the-counter supplements so this kind of makes things a bit more challenging. But at this point I’m open to anything.)

14 thoughts on “Slow and Steady

  1. Hi Vicki,
    Have you considered a gluten- and GRAIN-free ‘paleo’-style diet? I was already gluten-free for celiac (and I’ll admit, my ferritin is normal), but I can’t believe how much better I feel on a ‘paleo’ diet. And I do train on the bike, and I find I have as much power now as last year when I was eating plenty of (gluten-free) grains, without the blood sugar swings. [I did a couple of cx training sessions with you last fall]. Hope you feel better soon!
    Cheers,
    Kim

    • Hey Kim! Great to hear from you. I am on a gluten-free and dairy-free diet and I’ve explored the full Paleo option. In fact I think I’m pretty close since I stick to a very “clean” diet and don’t eat anything (except Clif Bars) that come in packages. Thanks for the suggestion. I do have the Paleo nutrition book for athletes (exact title escapes me right now) – I’ll give it another read and see what I can take from it. Thanks again! cheers, vicki

  2. Hey Kim!
    Great to hear from you. I am on a gluten-free and dairy-free diet and I’ve explored the full Paleo option. In fact I think I’m pretty close since I stick to a very “clean” diet and don’t eat anything (except Clif Bars) that come in packages.
    Thanks for the suggestion. I do have the Paleo nutrition book for athletes (exact title escapes me right now) – I’ll give it another read and see what I can take from it.
    Thanks again!
    cheers,
    vicki

  3. Hi Vicki,

    Once again, your situation seems to be extremely similar to my own. My UC flare was from Nov-Jan. I started logging easy base miles in February and felt horrible. Like you, my iron levels were way off, as was my hematocrit. My doctor has been more focused on the HCrit than ferritin, so I’m not really sure what my levels were for that. I suspect the two might be related, so I thought I’d share my experience.

    My HCrit was 28 when I was first tested in mid-Feb. A normal HCrit for me is about 40. My GI prescribed 325mg ferrous sulfate 2x daily and I was retested every 2 weeks. I gained 3-4 HCrit points every 2 weeks until mid-March. I noticed significant improvements in my cycling performance during this period.

    In mid-March my UC symptoms returned even though I was still tapering off of prednisone. I’m not sure why the symptoms returned… maybe my taper was too fast (I want to blame the iron but my GI says no), who knows. Anyways, the ferrous sulfate definitely made the bleeding worse and I had to stop taking it to let my guts heal. Seems kind of stupid to me. It was causing the original problem. What a vicious cycle.

    In mid-April my HCrit had dropped from a high of 35.6 to 32. I refuse to take the ferrous sulfate again, and I’ve been told to try 325mg ferrous gluconate 2x daily. From what I’ve read, this form of iron isn’t generally absorbed as easily, but it’s more gentle on the guts.

    At this point I’ve been taking the gluconate form for 7 days and it seems to have a much different impact on my digestion. ‘More gentle’ is a good description. Thus far I certainly don’t mind taking it like I did the sulfate form. It remains to be seen how much effect it will have on my HCrit levels.

    As for the HCrit levels, there seems to be a very strong correlation with my cycling performance. For me it’s more intensity related though. I really haven’t had problems doing rides 3-4 hours or longer, even on consecutive days. When my team is pushing the pace for town lines however, I can’t keep pace for long at all. I’ve been wondering if my relatively good endurance (considering my situation) is due to the prednisone that I’m still taking.

    I’ll let you know how the ferrous gluconate is working for me next week after I have another blood test. I’m dreaming of my HCrit being normal in mid-May and being able to race again. I’m told that if the gluconate option does not work for me, the next step is intravenous iron injections at least 1x weekly, maybe more.

    Hope this isn’t too irrelevant to what you were looking for. I’ll have to ask about the ferritin levels next chance I get. I appreciate you sharing your experience.

    Jay

    • Jay,

      Thanks so much for your detailed response. It seems like you and I are going through a lot of the similar things. So I’ve been getting weekly iron infusions fairly steadily since last October (with a break while I was sick). I’m now back on the infusions but they really aren’t doing as much as they should. Seems like the current thinking is that the Imuran could be causing some issues.
      Thanks so much for telling me so much about your experience -it does help to know that there are others out there.
      cheers,
      vicki

      • Vicki,

        Wow, I’m surprised to hear that you’re having infusions yet still so low on iron. I may be starting on Imuran in June, so I’d be interested to hear how that plays out for you. Best of luck!

        Jay

      • HI Jay
        Lots of absorption issues going on. I spent the day at the hospital on Wednesday getting poked and giving up lots of blood. Turns out my folic acid level is too low. I’ve had good success with Imuran but now I’m experiencing the known side effects of it: white blood cell count is too low and my red blood cells are too big – this has resulted in the anemia. So definitely pay attention to your energy levels while on the Imuran.
        Hope it all works out for you.
        cheers,
        vicki

  4. Blackstrap Molasses, Broccoli, Raisins cooking with an Iron skillet. I have read that
    Iron absorption needs other factors i.e. ascorbic acid/Vitamin C to be efficient. These are just a few things we have tried at home for general healthy eating. Get well soon.

    • HI Mike
      Very interesting – I actually wondered if such changes would make a difference. I have started eating more clams, mussels and oysters since these have very high iron levels. I will definitely incorporate your suggestions – I’m a big fan of broccoli and raisins and I think I can find some tasty ways to add blackstrap molasses to my diet.
      Thanks for the comment and for the support – much appreciated.
      cheers,
      vicki

      • Hi Vicki, I also have low iron levels although not for the same reasons that you do. In December my number was 10 which the doctor said was at the very low end of were it should be. I can take iron pills but i only take them occasionally because i prefer to try an up my iron by eating iron rich foods rather than pills. I have already been cooking with cast iron for a couple of years and also eat broccoli regularly but recently i have been adding the unsulphered blackstrap molasses to rice when i cook it and also to my tea in small amounts. It actually tastes pretty good. I havently had a retest of my blood since then but i will be soon so i am hoping it has made some difference. Kira

      • HI Kira

        Thanks so much for the comment. I have started eating lots more broccoli (excuse to make my favorite broccoli salad) and I’ve been adding raisins to lots of recipes now. I’ve been trying to get used to blackstrap molasses but wow – this stuff has a strong flavor. I think that buying a cast iron pan is the next step for me – many people have suggested this. I hope that your iron/ferritin levels are getting better – especially since you have that new bike! Thanks again for taking the time to respond.

        cheers, vicki

  5. Hi again Vicki,
    Umm, I know Clif is one of your sponsors, but the oats in Clif bars are not certified gf oats, so Clif bars aren’t gluten-free (and they are one of the ‘training ride’ foods I miss the most!! Hey, Clif, make a gf version!). I’m not trying to be a gf ‘evangelist,’
    it’s just that I have had gluten reactions myself from non-gf oat consumption… If the Paleo Diet for Athletes book is Cordain’s, I have read that one too… (I think he overcomplicates things!) I can’t say enough good things about regular red meat consumption (high in heme iron, the most bio-available kind). And if you are interested in any ‘grain-free’ cyclist-friendly ideas, email me…
    Cheers,
    Kim

    • Hey Kim
      Thanks for the information about the gluten. Yes, I know that the Clif Bars are not certified gluten-free – I have checked with my doctor and he says that since I don’t have a recognized gluten intolerance, that I can still continue to eat gluten. I have decided to remove simply as a precaution – so if I have gluten once in a while, I don’t really sweat it. The good news is that Luna protein bars are now certified gluten-free. I am trying to increase my red meat consumption and I’m also eating more mussels, clams and oysters since these are high in iron.
      Definitely, I’ll email you about the grain-free ideas – I think this is something that a lot of people would be interested in.
      Thanks again for the comments – I really do appreciate it. I hope your early season riding is going well – weather notwithstanding!
      cheers,
      vicki

  6. Pingback: Practical Paleo Nutrition Guide Book | HealthAndFitnessCure.com

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