Hi, I have a couple of queries but thought it would be best to layout my History first.I started running in 2006 for the London Marathon and was at that time smoking. I gave up in 2007 and that year competed in several other marathons and my times were pretty good. Then in 2008 I ran the Marathon des Sables and I am now training for another ultra marathon. I am not particularly fast but have been much faster. After the Marathon Des Sables I experienced very low iron and was on iron tablets for months, 600mg a day. That then was retested at the end of last year and I was fine. I have, however, not felt that brilliant. have been competing in marathons every two months and I just know I am fitter than my times indicate. Ever since my anaemia last year I have been a dedicated eater of spinach and taker of Iron, so I don’t think those levels are poor now. My queries are about two things really, and reached a critical mass today, my circulation and speed. I have started to get extremely bad circulation in my hands and feet, so that my fingers and toes go white and numb. That is combined with a feeling that I am just not getting enough oxygen. This morning I fainted on the train, my blood pressure was very low – 93/47 and I have been advised to go back to the doctor. Do you have any idea of what  I can do to increase my blood pressure in order to be really getting back on target time and stopping the circulation problems? Thank you, apologies for the long query. Jane


Dear Jane,

Standard blood tests can show a ‘normal’ result when in fact a functional deficiency can exist. Women of childbearing age require 18mg of Iron per day.  Do you have 4-5 other symptoms of Iron deficiency such as:

Fatigue particularly of muscular origin Learning difficulties Irritability Headaches Dizziness Constipation Heart palpitations Decreased appetite Fainting Pallor Weakness

It is important to note that these symptoms can be a result of other conditions but should form an overall picture if you are indeed suffering from Iron deficiency.

The circulatory problems may be as a result of not enough oxygen. Firstly we need to rule out the really obvious symptoms of whether your clothes are simply too tight around your armpits or upper legs? If this is not the case we need to review your diet for Iron intake and absorption. Some people simply don’t intake enough nutrients, others may not absorb them. A digestive disorder can decrease absorption as can interaction with other nutrients and foods. Tea, Calcium, Copper, Manganese and Zinc may reduce absorption, while a deficiency of Vitamins A, B’s and C may impair metabolism of Iron. Taking your supplement or eating Iron rich foods at the same time as a cup of tea will reduce absorption, so think about these factors. Ensure you have adequate amounts of vitamins A, B’s and C so your body can metabolise Iron. You may need to take a supplement for these if you don’t eat a huge amount of vegetables and fruits that are locally sourced or home grown as most nutrients only form at the end of their growing cycle.

Eating foods that increase circulation may help. Try incorporating more onion, garlic and spices such as coriander, cinnamon and chilli into your diet. You may also want to consider including Pilates, swimming and stretching exercises into your routine.

Another form of anaemia can be pernicious anaemia caused by low levels of vitamin B12. Other symptoms of B-12 deficiency include constipation, sore tongue and poor appetite. You should consider getting your levels of B12 checked and consider a daily supplement containing vitamin B12

Perceived rate of exhaustion may be lower than your actual rate – do you work out with a heart rate monitor on? I suggest doing so in order to keep track of your heart rate. I am concerned about your blood pressure and am not sure whether you have low blood pressure usually or if it was just on the day you fainted? I advise you go back to your Doctor and have it monitored to rule out any cardiac or pulmonary problems. If you don’t have symptoms of low blood pressure it may be that you are developing acute symptoms of it. There are people who normally have high blood pressure yet may develop symptoms of low blood pressure if their blood pressure drops to 100/60. Is your heart rate usually low or high? I would expect it to be between 40-60 for the amount of training that you are doing. Do you breathe properly – deep, even breaths. Had you fainted upon standing or after standing still for a long time? Discuss these with your health care professional as they will want to rule out adrenal insufficiency as a causative factor.

Another reason for fainting is low blood sugar. Had you eaten the morning you fainted? Do you get enough protein and complex carbohydrates after your training? The thinner you are the more at risk as you will rapidly lose blood glucose and electrolytes causing low blood sugar and dehydration. Make sure you are getting enough minerals in the form of a mineral supplement or a good quality electrolyte drink (not a sugar-filled sports drink masquerading as an electrolyte drink though!).

Stress can increase adrenaline that may cause dizziness if you have a sudden increase of it coupled with low blood pressure so try to take it easy, reducing any unnecessary stress.

Kind regards,

Emma Wight-Boycott Nutritionist

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