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It is normal for us as humans to feel tired. It can be a multitude of factors that contribute to our own personal fatigue; work, physical activity, and stress. When athletes feel tired it can be from a buildup of fatigue from a hard day of training, or due to a lack of recovery from a previous day. Feeling a bit off for a day or two is normal. Our bodies need time to recover and muscles can go through periods of fatigue for a few days. The problem is when that feeling begins to linger and become more pronounced, that is when flags should begin to raise. There are a large number of factors that can contribute to fatigue and it is best to always consult a physician if you feel that you suffer from chronic fatigue. For now, we can take a deeper look into a condition many of us face; anemia.

What is Anemia?

Anemia is a condition in which your body’s blood contains a lower amount than normal of red blood cells. Another way to define anemia, is when your red blood cells do not contain enough hemoglobin. It may get a tad confusing from sorting through different sources that talk about anemia, or “iron deficiency” but we can discuss it further to ensure there is no confusion!

Let’s break this down a bit:

Our blood is made up of a few different parts: red blood cells, white blood cells, platelets, and plasma. Each part of our blood serves a specific purpose and job. Red blood cells are made in the marrow of bones and are disc shaped and help to carry oxygen throughout our body. This is especially needed during exercise, when red blood cells are sent to our working muscles to help supply oxygen. Red blood cells also work to remove carbon dioxide from our bodies.

White blood cells are also created in our bone marrow and help us to fight off sickness and infections. Platelets help to form clots to stop further bleeding. All of these components of blood can be affected by anemia.

Another important piece of blood is, hemoglobin. Hemoglobin is a protein that helps red blood cells transport oxygen from the lungs to the rest of our body. Hemoglobin also helps to give our blood its red color. Iron, is an essential protein of hemoglobin that helps make this transfer of oxygen from the lungs to the muscles possible. Iron is also essential in the production of ATP (adenosine triphosphate), a key factor in our body’s energy source. Iron is not produced naturally within our bodies so it is essential that we obtain it from outside sources. Ferritin, is another key player in our bodies. Ferritin is also a protein that helps to transport iron and release it in the body when necessary. Ferritin is important to understanding and connecting anemia, hemoglobin, and iron deficiencies.

If an individual suffers from anemia defined by lower red blood cell count, your body will begin to fatigue faster. You can also remain in a state of fatigue for longer bouts of time as this condition progresses. When our red blood cell count drops, our body is no longer receiving the proper amount of oxygen rich blood to supply it with energy. Take exercise for example: when we begin a workout, our body senses this change in activity and makes it a top priority to send blood to our working muscles. When we do not have enough red blood cells there is a decrease in oxygen and our muscles are “starved” to put it in perspective. They are unable to complete the workload due to lack of oxygen being supplied. We begin to tire much faster than we had before and this is due to a buildup of lactic acid in our muscles.

If an individual suffers from anemia defined by low amounts of hemoglobin. Individuals may have normal levels of RBC, but if their hemoglobin levels are below normal, then our body’s can experience very similar effects to the anemia discussed before. Fatigue will begin to set in quickly, especially during efforts of activity in which we need oxygen supplied to our working muscles.

Individuals can also be affected by low amounts of Ferritin levels. This means that you may potentially have normal levels of hemoglobin and are only iron-deficient. This case is not as severe as anemia.

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These types of anemia and iron-deficiency yield similar symptoms: fatigue, weakness, shortness of breath, and headaches. Symptoms can also progress, and you do not want to leave this unchecked. Fatigue experienced through anemia can be different for each individual, and it is very prominent in athletics. Athletes can go day to day performing workouts and training loads in a normal routine, and then experience periods of time when it seems as though no amount of physical rest will help them recover. It is vital for athletes to get their blood checked regularly to monitor their red blood cell levels as well as hemoglobin. What may seem like small decreases in each can have drastic effects on some individuals. Creating a baseline level is crucial to optimal performance. Being able to catch slight drops in levels can help save a season of training.

Combating Anemia and Iron Deficiency

There may not always be one finger to point when it comes down to determining the root cause for why individuals are affected by anemia. A few large factors (especially when it comes to athletics) can include an improper nutrition, improper absorption, increase in training (duration and intensity), and blood loss. Blood loss is especially true when speaking to the female population as they go through menstruation monthly.

According to the National Institute of Health, the RDA (recommended dietary allowance) for iron is 16.3–18.2 mg/day in men and 12.6–13.5 mg/day in women older than 19. While most of us may hit this range daily, individuals performing and competing at high levels daily, may have a harder time obtaining this level. Ensuring that we are consuming proper amounts of nutrients is vital to maintaining normal iron levels. Eating foods that are iron rich can help combat anemia. These foods include: spinach, lentils, quinoa, and meat (beef and liver.) It is always best to receive your iron sources from food before you go to supplements.

Finally, sometimes it is best to just give your body what it needs: rest. We cannot sustain tremendous amount of load for a year. We must train in blocks of time and give ourselves days and weeks to recover after each. When we are training, we are destroying red blood cells as we work, known as “exercise-induced hemolysis.”

Sometimes our bodies know what is best for us. It is quite incredible how quickly we can detect changes in blood levels and fatigue levels. Having a better understanding of where fatigue may be coming from, can help us correct it that much faster. As stated previously, it is best to go for routine blood work if you think you may be falling victim to anemia or iron deficiency. Always consult with your doctor prior to starting any exercise changes or nutritional changes.

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