Anemia

Anemia – tired and you don’t know why

Over the years, we have encountered a number of young female athletes suffering from slower than normal running times, who have, with a doctors help traced the cause to anemia.   As more young females enter the athletic fields this becomes a condition we all should be aware of as it mainly affects women.  Here is a brief synopsis of my research.  If you suspect anemia, please seek a doctor’s help.

Anemia is a condition in which the production and amount of your red blood cells is below normal.   A low red blood cell count means less oxygen is being delivered to performing muscles. Because oxygen is essential to burn the calories used by muscles in aerobic exercise, this can have a direct effect on your ability to perform.

Symptoms of anemia correlate to some degree with the severity of the anemia. Most mild anemias cause no symptoms, although an athlete may notice more fatigue during workouts, a feeling of burning or heaviness in the legs, a difficulty in doing speed work and nausea after a workout. If the anemia is severe you may be lightheaded upon standing, fatigued during daily activity and have headaches.

Testing for anemia is done by a doctor either via finger prick or drawing blood from a vein. Initially two screening tests are performed. The hematocrit test measures the percentage of plasma that red blood cells comprise and the hemoglobin test, which measures the grams of hemoglobin per 100 milliliters of blood volume. There are normal ranges for these tests and the doctor uses them to determine where to go next.

Some researchers have found that, on average, women participating in aerobic training have lower blood values than non-athletic women. The reason is not a strange athlete’s anemia, but a beneficial adaptation to exercise.  With training, the body expands the fluid compartment of its blood volume. This expansion of volume allows more efficient delivery of red blood cells to exercising tissues, but also results in a dilution of red blood cells, thus lowering the counts on screening tests above.

However, more common is iron-deficiency anemia, sometimes called “tired blood.” A molecule of iron is needed to make part of a protein called “hemoglobin” which is the essential protein that carries oxygen in the red blood cell. Without adequate iron, your body is unable to make new red blood cells.

Experts estimate that between 20 and 65 percent of young American women are iron deficient and up to 20 percent are frankly anemic. Many factors contribute to your risk of becoming anemic. They include a diet low in iron, restricted calorie intake, eating disorders, heavy menstrual flow, pregnancy and lactation, and blood donations. Bleeding in the gastrointestinal tract from a variety of causes, including the excessive use of anti-inflammatory medications such as aspirin and ibuprofen, can also cause anemia.

The more common cause of anemia in women is the lack of iron in their diet. Women need nearly twice as much iron as men (18 milligrams/day compared with 10 mg/day) because of menstrual blood loss.  Heavy exercise may also increase iron needs by up to another 1 to 2 milligrams day. This may be caused by a combination of factors, including iron loss in sweat, blood loss from the urinary tract or gastrointestinal system and the breakdown of the red blood cells in the circulation from heavy foot striking (foot-strike hemolysis).