The Thing About Iron
Hello everyone, Mitchell Hollis here with Run for God. I want to start this blog off by making a few statements. First, I am not a medical doctor, nor any other kind of doctor. I’ve never been to medical school, and I do not claim to know much about the human body. This blog is not meant to diagnose anyone of anything, but rather tell you of my experience. Should you need medical advice, please contact your physician.
Now that all of the disclaimers are out of the way, let me tell you about why I’m writing a blog on the subject of Iron and Ferritin.
I have a 14-year old son named Lane Hollis. Lane in many ways is your typical freshman high schooler. He attends public school, makes good grades, plays the guitar, and loves hanging out with his friends. But there is one thing that is not so typical about Lane. He’s a very focused nationally ranked triathlete who trains 15-20 hours per week and has some pretty lofty long-term goals. He runs a mid-17 5K, and his current PR in the mile is 4:56. He’s also experiencing that dramatic change every young man experiences when their voice changes and they seem to grow 6-inches over night. With this background let me explain what happened.
On September 1 of this year, I showed up to Lane’s cross-country practice just like any other day. As Lane walked into the area where we all meet for practice, I could tell that something was wrong. He walked up to me and said that he did not feel good. Now let me stop right there and say, Lane is almost never sick, he never complains, and he’s always ready for a good practice. So when he told me he didn’t feel good, there was no question at all that something was wrong.
We immediately left the practice and walked in to our local family care physician to get him checked out. Lane was pale, weak, and fell asleep in the waiting room. My first thought was the flu or some other random bug that kids pickup this time of year. After a few minutes we were able to see the doctor and after she checked his temperature we found that he had a 101.9 fever. That would explain why he felt as though a truck had hit him, but what caused the fever?
After she had checked for the flu, strep throat, and ran a urine sample she came back into the room somewhat puzzled. Everything came back negative. He didn’t have any of those things. She indicated that he may just be fighting off something and he’d be better in a few days. Sure enough, by Sunday he was back to what seemed like normal, at least until he showed up for XC practice on Monday.
On Monday following his fever, Lane showed up to XC ready to go. Lane came into the season as one of the top runners as a freshman and was ready to start this season off right! As soon as Lane started running his warm-up, he knew there was something wrong. He couldn’t get his legs to work! He said that he felt fine, nothing hurt, but he was having a hard time holding an 8:30 pace. Lane’s slow zone at the time was 7:00-7:30. He finished practice frustrated, but not too worried. We assumed that the fever he had on Friday must have taken more out of him than we thought. Tuesday and Wednesday was the same story and it was Wednesday afternoon when I realized we needed to head back to the doctor. I made an appointment for Thursday afternoon, and let his coach know that we would not be at practice.
On Thursday, I picked Lane up from school and once again he stated that he felt great. By this point I’m thinking that something else is going on and the fever may have just been a coincidence? As we met once again with his doctor I asked if we could get some blood work to see if there was any kind of imbalance. I had read about athletes, especially female athletes, who had performance problems due to low iron. Right away, he sent Lane back to the lab for a CBC (Complete Blood Count). The doctor told me that he’d give me a call later that afternoon with the results. This is it! I just knew this was going to be the problem. I got the call later that afternoon, but it wasn’t the call I was hoping for. Everything was normal. It’s strange to say that I was disappointed with a normal result, but we knew something was wrong, and once again we hit a dead end.
On Friday and Saturday Lane’s run only seemed to get worse. You could tell by looking at him run that something was very wrong. He almost seemed uncoordinated and it looked as though he had trouble just putting one foot in front of the other. On Monday, his XC coach (a great friend and coworker), and I were talking about what might be going on. We’d been to the doctor twice and everything was normal, maybe it’s just that he’s going through a growth spurt? Lane had grown a couple of inches in a short period of time.
I’ve coached triathletes for many years now and I’ve seen the effects that growing can have on kids. Their body awareness gets out of wack, and they’re just not aware of how tall they are getting which can spell big trouble when it comes to running efficiently. That must be it, so we went with it. For the next two weeks, we backed Lanes volume down and had him do other workouts when the rest of the team was doing speed. High intensity and growing quickly in many cases can lead to injuries and we just wanted to let Lane get through this.
Asking Lane to run less than everyone and not run hard is like asking a basketball player not to dribble the ball. It just didn’t make sense, and if it did, he was not happy about it. One day at XC practice almost a month since he first had his fever, I could see that this was getting to Lane. He was upset, which in turn made me upset. Something just didn’t feel right! He had grown, but not that much! And if it was a growth spurt that was leading to coordination issues then why were we not able to see it anywhere else? If it’s that bad, then it should be at least a little noticeable just walking around while not exercising. It wasn’t.
That evening I got on the phone with a coaching friend of mine out of Des Moines, Iowa, Jenny Weber. Jenny is a high-performance triathlon coach and the head coach of Z3, which is a high-performance team that Lane is a member of. I began to tell her about what was going on with Lane. She listened and said, “It’s his Ferritin”. There was no hesitation. I knew Ferritin had something to do with Iron and I told her that his CBC, which does check for iron, came back normal. Jenny calmly ensured me that a CBC does check hemoglobin, which is the iron-containing protein in the blood that carries iron and oxygen to cells, but it does not check for ferritin, which indicates the amount of iron stored in the body, almost like your iron reserve tank.
It all made sense, but I still wasn’t getting my hopes up. That night I read article after article about this very thing, and how low ferritin would affect athletes in exactly the same way that it was affecting Lane. But why didn’t anyone tell us this? Why didn’t anyone explain the difference between hemoglobin and ferritin? Why did the doctors miss this? Because while this condition is very common in young endurance athletes (some estimates are as high as 40%), it’s very uncommon with the average active young person. The average active young person is not training at the volume and intensity as Lane and many of his peers are. This is exactly why someone who coaches athletes such as Lane was able to quickly point this out when doctors didn’t.
Needless to say, Lane was happy to get his blood drawn once again the next morning for a specific ferritin test. Unfortunately we would not get the results until Friday and this was only Wednesday. For the next two days we were on pins and needles. We stuck to our plan of low volume, low intensity, and as much as I wanted to go ahead and get him on an iron supplement, I didn’t.
Friday, the call came in and it was the news we wanted. Lane’s ferritin was extremely low. What a relief! Crazy right? I’ve never been so excited to hear that something was wrong with one of my children. It was because we had an answer. We knew what the problem was and now we could work to fix it.
The “normal” range for ferritin in a young athlete such as Lane is 70-300. Lane’s was 11. That Friday afternoon Lane skipped XC to get a crash course on how to manage your iron naturally as well as to find out a supplement regimen for his iron deficiency. We decided on 65mg of iron with vitamin C twice a day until his levels are back to normal.
So what caused the fever a month ago? We’re not real sure, but I have read that in some cases low ferritin can lead to infection, which would explain the fever.
So what caused the low ferritin? Again, I’m not sure, but I assume that when you couple the fact that Lane trains year round with the fact that he’s currently growing like a weed, deficiencies are going to occur.
There are still some questions that may never be answered, but there’s one thing for sure. The solution worked. Lane took his supplement on Friday afternoon, two on Saturday, and raced the final triathlon of his season on Sunday. He was back to the old Lane, claiming second overall against a strong field of athletes two and three times his age.
One thing I found during this 4 weeks of not knowing what was going on with my child is that answers were hard to find. Reading clinical studies, visiting the doctors office three different times, and conducting trial and error experiments that only lead to dead ends was not the easiest route. I only wish I had read Lane’s story that someone else had written from the very start. My hope is that this story will find its way to those who are searching for the same answers as me.