Training & Nutrition - Anemia and Cycling / Endurance Sports

I've been dealing with a mystery anemia for at least a year now.
My local docs can't seem to find a cause. I'm currently researching specialists in the "big city".

Anyway - here's where I'm at:
At my lows my hematocrit levels were high 20's.
Average is low 30's.
Hemoglobin is low
MCV is low
MCH is low
Red Cell distribution width is high
Reticulyte counts are high
All other baseline blood work looks normal

Iron absorption fluctuates - I'm on a supplement now
I've been tested for Celiac's Disease (negative)
Biopsy of my stomach lining and intestine showed nothing unusual
Ednosopy showed nothing unusual
Colonoscopy found nothing unusual

I have a thyroid disorder - I'm hypo

I ride long distance - focusing on Brevets.
Recovery between efforts (if its a bad day or week) seems to take forever.
I feel like I hit a wall - and even if the mind and legs think we can go, the rest of me can't. Sometimes I simply can't go any harder. (This is usually when I'm already going pretty slow, compared to last year) I did my 200k and 300k just after getting some of the lowest blood results I've had... my doc can't wait to see the levels get back to normal and see how I do with training / riding - he just hasn't been much help.


I've found a few references to endurance athletes and anemia - esp runners - and in "Serious Cycling" I read that Greg LeMond was feeling sluggish and after some bloodwork was found to be anemic at some point in his career...



Can training / diet be influencing this?
Anyone else out there dealing with anemia?


I'm worried that this is more than just "Sports Anemia" or iron deficiency...
I'm at a loss.

Have they checked for any kind of kidney disease? 1 year is a long time to suffer with anemia with no diagnosis.

Can training / diet be influencing this?
Anyone else out there dealing with anemia?

I'm worried that this is more than just "Sports Anemia" or iron deficiency...
I'm at a loss.

I'm not a doctor... and I didn't stay at a holiday inn express last night...

training / diet influences a lot more, IMHO, than most people (sometimes Doc's included) realize....
I don't know your training / diet habits but it's sure worth monitoring in conjunction with checking with Dr's...

Are you under 40? do you Gu a lot? sports drinks often?
I think a lot of athletes rely on those more than necessary.

I hope it's nothing serious bmike...
Be well :)

Yeah, it used to be a "big deal" that endurance athletes would "test out" anemic...... More females than males. For whatever reason, it doesn't seem to be that big of a problem these days. At one time, it was thought that anemia was always caused by iron deficiency.

Have you searched your family tree for signs or symptons of genetic blood diseases from ancestors?

do you know your sedimentation rate for your urine?

@riphRaph - I have sed rate results somewhere... my memory says that it didn't alarm anyone.

@Richard - researching the family tree now - my mother is looking into something odd happening with an aunt - she's getting regular IV's - speculation is it might be iron.

@Slow and Steady - Kidneys are working fine, as far as I know - and as far as my blood work hasn't alarmed anyone

@LilSprocket - I'm 32, Hammergel / Gu alot, did try to keep a liquid diet on "event" rides (brevets) - but that's changing as I've been experimenting with real foods


Going for acupunture this week - specifically for the anemia as well as looking at my mild hypertension - and then starting to work with a nurtritionist. (that's going to be ugly - my diet goes all over the place - especially when its the peak of cycling season!)

I'm also waiting till mid October for my pending marriage so I'll have access to better health care - Currently as a self employed (or rather "unemployable") worker bee I buy my own health insurance - my fiancee has access to fantastic docs at reasonable rates (compared to mine!) I've shelled a ton o $$ out of pocket for tests and visits and consults and procedures.

I'll be exploring more traditional docs and diagnosis, as well as continuing with the non traditional approach if it seems to be working.

I've been dealing with a mystery anemia for at least a year now.
My local docs can't seem to find a cause. I'm currently researching specialists in the "big city".

Anyway - here's where I'm at:
At my lows my hematocrit levels were high 20's.
Average is low 30's.
Hemoglobin is low
MCV is low
MCH is low
Red Cell distribution width is high
Reticulyte counts are high
All other baseline blood work looks normal

Iron absorption fluctuates - I'm on a supplement now
I've been tested for Celiac's Disease (negative)
Biopsy of my stomach lining and intestine showed nothing unusual
Ednosopy showed nothing unusual
Colonoscopy found nothing unusual

I have a thyroid disorder - I'm hypo.


Has your doctor done tests for autoimmune diseases or red blood cell parasites like Babesia or Leishmania? These would be other considerations.
- Scott

Can training / diet be influencing this?

Did you know that anemia is one of the many symptoms of overtraining? An excerpt from a sports science journal:

It has also been hypothesized that chronic elevations in 5-HT concentration, which may occur in athletes maintaining high-volume training, explains some of the reported signs and symptoms of the overtraining syndrome: postural hypotension, anemia, amenorrhea, immunosuppression, appetite suppression, weight loss, depression, and decreased performance (Newsholme et al., 1991; Gastmann and Lehmann, 1998; Kreider, 1998).
http://sportsci.org/jour/9901/rbk.html

Do you have any other common symptoms of overtraining?

Did you know that anemia is one of the many symptoms of overtraining? An excerpt from a sports science journal:

It has also been hypothesized that chronic elevations in 5-HT concentration, which may occur in athletes maintaining high-volume training, explains some of the reported signs and symptoms of the overtraining syndrome: postural hypotension, anemia, amenorrhea, immunosuppression, appetite suppression, weight loss, depression, and decreased performance (Newsholme et al., 1991; Gastmann and Lehmann, 1998; Kreider, 1998).
http://sportsci.org/jour/9901/rbk.html

Do you have any other common symptoms of overtraining?

Thanks for that info Terry.

My first results came back last fall - when I was just ramping up my mileage - so I don't think that it would have initially been overtraining. My brevet schedule and getting my mileage up to handle it could have compounded the problem - no doubt.

I did my 200k and 300k with some really low blood numbers - I kept telling myself as I struggled along "You're doing great - for an anemic guy!". My fiancee who is a clincal researcher was pretty weirded out by the results - we are tracking down docs in Boston that might be better suited to help than my "hometown" doc.

I'll look into the overtraining and read through that link - anything's possible at this point. I've dropped my mileage down quite a bit from midsummer. Still feeling fatigued. I'll be getting some new tests done in the next month and reinvigorating my search for why this is happening.

Has your doctor done tests for autoimmune diseases or red blood cell parasites like Babesia or Leishmania? These would be other considerations.
- Scott


We did look for Celiacs Disease - both the blood test and the biopsy for this came back negative.
We did not look for parasites though. Something else to add to the list of questions.

@LilSprocket - I'm 32, Hammergel / Gu alot, did try to keep a liquid diet on "event" rides (brevets) - but that's changing as I've been experimenting with real foods

then starting to work with a nurtritionist. (that's going to be ugly - my diet goes all over the place - especially when its the peak of cycling season!)
I'm also waiting till mid October for my pending marriage so I'll have access to better health care - Currently as a self employed (or rather "unemployable") worker bee I buy my own health insurance - my fiancee has access to fantastic docs at reasonable rates (compared to mine!) I've shelled a ton o $$ out of pocket for tests and visits and consults and procedures.

I'll be exploring more traditional docs and diagnosis, as well as continuing with the non traditional approach if it seems to be working.

Keep the gurl with good health care... ;)

Try to avoid "waiting" when it comes to your health though...
If you lack your health, you will lack in every other aspect

Working with the nutritionist sounds like a REALLY good move bmike... Really good move

Please keep us posted, I have great interest in your well-being :)
Be Well! :D