Several years ago I noticed I was getting out of breath pretty easily, not only when I ran but also when I would do other things. The last straw was when I went up a flight of stairs at home and was so dizzy and out of breath I had to grab the wall to steady myself when I reached the top. I scheduled an appointment with my doctor the next day and was told my hemoglobin level was low- I was anemic. This was round one of my battle with anemia. For the record, in the United States, anemia is diagnosed if a blood test finds less than 13.5 g/dL in a man or less than 12 g/dL hemoglobin level in a woman.
After taking a prescribed dose of iron in combination with vitamin C, B12, and folic acid for months, I started feeling somewhat better, but honestly, it was more than a year or so after I was diagnosed with anemia before I felt like I did before the diagnosis. In the midst of all of this, I ran a half marathon in Oklahoma in March of 2011. It was one of the hardest half marathons I ever ran because of my anemia, and not suprisingly, one of my slowest. I ran another half marathon in Montana four months after that and one in Alabama four months after the race in Montana. Finally, in March of 2012 when I ran a half marathon in Virginia did I start to feel like I was getting back to normal, one full year after the race in Oklahoma and more than a year since I was diagnosed with anemia.
Now, I absolutely want to emphasize that I do not think it’s a good idea to run half marathons when you’re anemic. In fact, my doctor flat out told me I shouldn’t be running at all, let alone running half marathons. However, I did run, albeit much slower than I would have otherwise, but I’m stubborn like that.

Fast forward to present day, well actually more like summer of 2018. I felt very out of breath when I would run, and it seemed to be getting worse. I chalked it up to the extremely hot, humid summer we were having. When it finally cooled off and the humidity dropped, and I was still out of breath on runs, I began to think maybe something was wrong. When I went on a long run and had to stop to catch my breath before I even reached a mile, I knew for sure something was wrong.
I bought some over-the-counter iron supplements and began taking them. Still, it was getting worse. Once again, I was out of breath after just going up one flight of stairs at home. I went in for some blood work at my doctor’s office and the results came back several days later- my hemoglobin count was 6 (normal for women my age is 12-15). This was even worse than the last time I was anemic. I should say too, that the last time I was anemic, I saw three different doctors and after having multiple tests done, all of the doctors just shook their heads and said they had no idea why I was anemic. There was no apparent reason- I’m not vegetarian and I didn’t have a recent large blood loss.
What all of this means is it’s been extremely difficult for me to train for my next half marathon, coming up in two weeks. Since it will be state number 44 for me, I feel a need to still do it, even if it means I have to walk or run/walk the entire 13.1 miles! I’ve set the bar and my expectations low for this next race, with the goal of simply finishing it. Right now, that’s good enough for me.
Now a short PSA- if any of you female long-distance runners reading this haven’t been feeling quite yourself lately, such as you get out of breath easier than you used to, you feel light-headed or dizzy during or after exercise, or your resting heart rate is higher than it used to be, go to your doctor for a simple blood test to check your iron. They will check your hemoglobin level, which is an easy way to check your iron since most of your body’s iron is in the hemoglobin of your blood. Here’s a good website with some general information from UCSF Health worded in a way I really like: Hemoglobin and Functions of Iron.
I specifically say female long-distance runners here because in endurance athletes, ‘foot strike damage’ to red blood cells in the feet due to running on hard surfaces can lead to iron loss. Iron is also lost in sweat, so if you sweat heavily (like I do), you have an increased risk of iron deficiency. These two things combined with monthly blood loss through a woman’s period can all add up to significant iron loss. I suspect that’s what happened with me. That and I also had given blood a couple of months ago, which is most likely what caused my iron stores to plummet.
Have any of you ever experienced anemia or know someone who has? Do you think you may need to get your hemoglobin level checked?
Happy running!
Donna
Angela of SF Road Warrior wrote a 3-part blog post about her experiences with anemia, which I found to be super informative and enlightening. http://sfroadwarrior.blogspot.com/2018/05/adventures-with-iron-deficiency-part-1.html
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I’ll check that out. Thanks!
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Oh no! I hope it doesn’t take as long to feel normal this time around as it did last time. I keep telling myself to go get my bloodwork checked for a few reasons but keep putting it off.
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I know it will take at least a few months, probably more. It does help some having already gone through it, so I know I’m not going to bounce right back to normal that quickly. I hope you’re able to get your bloodwork done soon.
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So sorry to read that your anemia came back! I know it was common in the high school girls I used to teach, especially if they were athletes. I think most of the over-the-counter iron supplements you usually take are not going to provide very much BIOAVAILABLE iron. Most of them contain reduced iron, which means shavings from a nail! It’s in a form that your body can’t use.
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Thanks, Laurie. You make a good point about iron supplements. It’s also nearly impossible for female athletes to get enough iron through diet alone, so unless you’re taking an iron supplement that your body can actually absorb, you’re not going to get enough iron.
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Thank you for sharing your journey. This is so informative and very helpful for many runners and women.
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Thanks, Sarah. I’ve read that an estimated 50% of all female endurance athletes are anemic, many of whom have no idea. Often, we blame other things if we’re more tired than usual after running (like we haven’t been sleeping well or we’re getting older, etc.), when the true cause may be anemia.
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