Blood and the Endurance Athlete

Disclaimer:  I am not a doctor, have no medical training, other than Boys Brigade first aid in 1985, and I accept no responsibility for any nonsense you get up to on the back of what I am about to write.  Consider yourself warned, or disclaimed, or something.  I also have no affiliation with any company that I mention in this blog.

I recently had a full blood analysis carried out.  I’ve used Blue Horizon Medical in the past for various testing when I have been wanting to discover more about how my body works under pressure during heavy training and if there was any nutritional or functional (training/rest/recovery) changes I could make to improve or adapt.  I did this testing when I started to train for the ACP 2016 and half way through the training block.  I didn’t blog about it at the time, mainly because nothing came up in the blood panel, all looked normal at the time.

So it was a surprise to see a few red flags in the latest blood panel when my training has been somewhat subdued over the last 6-8 months.

The first and probably biggest red flag was below normal HCT (Haematocrit) and Haemoglobin.  For an endurance runner these are of particular importance as they constitute the oxygen carrying red blood cells that supply oxygen and other nutrients to the working muscles.  My HCT was 0.39 or 39% and Haemoglobin was 129 g/L (normal range is 130 – 170 according to the lab where the test was carried out).  You might think that they are just below normal and I have nothing to worry about.  That may well be true to your average Jocky MacJockface on the street. Considering the average Jocky has an HCT of 45% (source Wikipedia), 39% is a worrying number.   WADA (World Anti Doping Agency) have a limit on HCT of 50%, anything over that and you are suspected of doping with EPO.  I’ve also read that steroids can boost HCT too.

Over the years I have read many books about pro cycling.  Although not a cyclist, I am intrigued with the sport, love watching the grand tours, the one day classics etc.  It is fabulous to watch.  Its dark side has also had me captivated.  One thing that sticks in my mind is the micro dosing of EPO.  The reason they micro dosed was to ensure their HCT didn’t go above the WADA limit of 50%.  These guys already started with HCT levels of 43-48% and look at the performance gains they got from marginal increases.  Now imagine the exact opposite, the marginal decreases in HCT and the affect that has, and that is where I am right now!

Don’t worry, I am not about to purchase some Chinese EPO online and start stabbing a needle in my a$$ each day.  Needles don’t worry me, I’ve had plenty blood taken over the years and have my fair share of tattoos.  Apart from the moral implications of doping, the thought of actually having to jab myself makes me boak!

From what I understand, a low HCT with a low MCV (Mean Corpuscular Volume) and a high RDW (Red cell Distribution Width) can be a sign of iron-deficient anaemia.   My readings for MCV was 83 fL and RDW of 14.2, these are on the boundary of what is considered low for MCV and high for RDW (again according to the lab’s thresholds).

Of course, this is all self diagnosis and that can be dangerous, but the basics are there to see, even with my limited understanding.   The numbers mean I could be slightly anaemic, possibly just a short term thing, maybe not.  There are other, more serious, reasons that could account for the values, but I am not concerning myself with those, because other than when I train, I feel ok.   What is puzzling me is that I do eat iron rich foods, heme iron and non heme iron, daily.  I take care to consume these iron sources with vitamin C sources to maximise absorption.  It’s nutrition 101.

Folate, B12 and Ferritin levels were all within the normal range, on the low side again, but still within that lab’s normal parameters.

So what’s the solution?  The solution I am going for is to supplement and make a few changes to diet.  Thorne Research do an iron supplement called Ferrasorb.  I’ve used Thorne products in the past and they are expensive, but they one of the best supplement companies and I am hoping this is short term.  Additional to that will be the recommencement of the consumtion of more organ meat, Mrs T will be delighted about that.  Liver, heart, kidney, even good quality black pudding will now need to feature weekly in my diet, I feel a few insta photos of some breakfasts coming up!!

[edit: first breakfast shot post writing]


The remainder of the blood panel was looking quite favourable.  Cholesterol, HDL and Ratio (the important parts) were within range, as were vitamin D, Thyroid function, liver function, calcium and Uric Acid.  CRP or C-reactive Protein is a good marker of inflammation in the body and my levels were very low.  Meaning, general inflammation is also very low.  Could this mean I am over the injuries, or at least getting over them?

Overall, I think the testing has been worth it.  As endurance athletes we need to know what is going on endogenously as well as the exogenous results from training and racing.   There have been times in the past where I’ve been training hard and getting nowhere with progression, maybe a test like this could have thrown up the reason why there was not forward movement.

I plan to have another test (the same one) in 4-6 weeks, after I have given my body enough time to adjust to any changes in diet or supplementation.  My hope is that I can resolve the problems with food and avoid any medical intervention.

If you follow me in instagram or twitter or facebook you may have noticed that I have been spending a fair amount of time in the gym.

I am actually quite enjoying it.  When you are given a programme to work on, that you trust will fix all the broken bits, it makes it so worth while.  As I age (I’ll be 28 this year), this supplementary must be part of your running.  You can’t live life with regrets, but if I did have one it would that I started this additional work 10 years ago! (when I was 18).

In terms of running, I’ve been doing a little.  The foot injury appears to be on the mend apart from a flare up now and again, so I have to be careful with that.  Managing it to resolution is the key and I have a way forward for that.  The groin issues that I have had for about 18 months are markedly better, probably due to the gym work and the physio sessions I have had recently.  I can’t thank Ross at Space Clinics enough for the work they have done to put this old body back together. It was worth every penny and I would not hesitate to return should another problem crop up.

I’ve also had some initial chats with a coach (which reminds me I need to tell them what the latest situation is!!!), with the view to getting some expert advice on the way forward.  I don’t feel quite fit enough yet to get onto ‘the programme’ but I am hoping over the coming months that I can transition to their planning.  It will be a new departure for me and one I am quite excited about.

Until next time.

3 thoughts on “Blood and the Endurance Athlete

  1. Nice article rob. I see a haematologist twice a year and have little idea what she goes on about. This helps a little, so time for some tough qs when I see her in July. Before my warfarin and current mess I had to self inject twice daily for two years so I can fully understand the needle thing.
    Good luck with the racing take care and enjoy!


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