I Think I understand Why I'm Not Getting Enough Iron

This is a follow-up on yesterday’s post about anemia.

As I mentioned in my last post, my anemia could be a nutritional issue, or it could be a symptom of some other medical condition.  I’m now fairly optimistic that it’s a nutritional issue.

There are two sides to that.  I need to get enough iron in my diet, but I also need to absorb the iron I’m eating.  I think I’m getting enough iron, but I don’t think I’ve been absorbing enough of it.

To absorb iron, it’s important to get enough vitamin C.  I don’t think that’s a problem.  I eat a lot of fruit, including tangerines and cherries, which are both good sources of vitamin C.  I also take a multivitamin that included vitamin C.

There are a number of foods which can interfere with the absorption of iron.  That’s where I think my diet has been a problem.

I think like an engineer.  For most of my life, I was a software developer.  A big part of my job was diagnosing and fixing problems.  If something used to work, but now it doesn’t, the first question I ask myself is, “What changed?”

I made major changes to my diet 15 months ago.  I used to be on a typical American diet.  Now, I’m on a Mediterranean diet.  If the dietary changes I made 15 months ago were causing problems, why did I only recently start having problems?  With that in mind, I started to look for more recent changes in my diet.

Yesterday, I started taking an iron supplement.  When I read the instruction sheet, I saw this: “Some foods like eggs, whole grain breads, cereal, dairy products, coffee and tea may made this drug not work as well.”  I also read elsewhere that coffee, tea, and dairy products can inhibit the absorption of iron.  That’s when the light bulb went on.

I’m not a coffee drinker, and I seldom eat eggs or cereal.  I drink tea in the morning, but that’s not a recent change.  I’ve been drinking tea for years.  My diet includes whole grain breads, but that’s also not a recent change.  What did change recently is the volume of dairy products I consume.

In January, I started drinking warm milk in the evening to help me get to sleep.  Most nights, I drink one cup of milk.  Some nights, I have a second cup.  Drinking a cup or two of milk each night was a big change to my diet.

The timing makes sense.  I started drinking a lot more milk in January.  Since then, I haven’t been absorbing enough iron.  By March, I was starting to have some disappointing race results.  By April, I was much slower.  Every month since then has been worse, as my iron levels kept declining.

In addition to taking an iron supplement, I’m making a few changes to my diet.  The biggest change will be eliminating the evening milk.  Instead, I’ll drink tart cherry juice, which also helps with sleep, but won’t inhibit absorption of iron.  It’ll actually help with absorption, since it’s a source of vitamin C.

I’ll still drink tea, but instead of 3-4 cups per day, I’ll cut back to one or two.  I'll still drink tea with breakfast, but instead of drinking tea with my lunch, I’ll drink orange juice, which also gives me more vitamin C.

With these changes, I should be able to absorb enough of the extra iron.

I haven’t ruled out other possible causes of my anemia.  I still plan to have a colonoscopy to screen for colon cancer, but I’m hopeful that’s not the problem.  I would’ve been due for a colonoscopy next year anyway.

Before I can get better, I first have to stop getting worse.  Recently, I’ve been getting significantly more tired from one month to the next.  Hopefully, my iron levels will now stabilize.

It’ll take longer to actually feel better.  It takes time to produce red blood cells.  I expect it’ll take at least a few weeks before I start to have more energy.  It’ll probably take a few months for my iron levels to get back to normal.

I have several races scheduled next month.  Those will still be slow.  Summer races tend to be slow anyway.  I’ll be content just to finish.

My more important races aren’t until the fall.  By then, I’ll hopefully be feeling better and running stronger.

One of my biggest goals every year is to qualify for the Boston Marathon.  Right now, I can’t come anywhere close to running a qualifying time.  Fortunately, I’ve already qualified for next year’s race.  Qualifying for 2028 won’t begin until September, and I’ll have almost a year to get a qualifying time.  I can afford to be patient.