Ferritin and triathlon

I mentioned in the last post about getting a Ferritin level in addition to a Complete Blood Count with differential (CBC with diff).  I will give you an example of a triathlete followed by this method.

As you can see, the deterioration is not only related to decreased Ferritin but to decreased blood cells in general, and with a simple CBC with Ferritin we can have the necessary information to follow this athlete properly.  In our experience, we have not seen athletes with other deficiency with a CBC as the one we have shown above; meaning no vitamins´ deficiencies or minerals, Ferritin level 38.  We controlled calories and the diet is considered to have all the nutrients by a dietitian.  The athlete is well-educated and knowledgeable about nutrients.  But, he is an athlete that needs to augment the amount of proteins after a hard workout in addition to increasing the iron intake.  The CBC and the parameter of Ferritin tell us that iron is necessary if we want to increase the production of viable red blood cells (RBC); meaning RBC that could transport the maximum amount of oxygen.  Hemoglobin in the blood cells should be at its maximum limit (MCH), if we want to take advantage of oxigen transportation via RBC.  MCH has been decreasing on this athlete from previous CBC.

There is a condition with low RBC that mimics the lack of iron in blood named Anemia of Chronic Disease, which should be differentiated from iron deficiency anemia by the amount of Ferritin and the medical history of a chronic illness, kidney, heart, infection, etc., related.  Normal or above normal ferritin is present with Anemia of Chronic Disease in addition to low RBC and the known medical condition.

There is no “scientific proof” of why Ferritin is decreased in endurance athletes as triathletes.  But that is a reality and we see it.  I.V. iron will be necessary to increase the amount of iron available to convert it in hemoglobin-iron.  We are not advertising doping by any means but increasing hemoglobin increases performance as we can see in this research.

I read that Kenenisa Bekele has had a hematocrit of 49, compared to the 42 of Haile Gebrselassie.  We do not have the conditions of how they took the blood sample to have a better context in order to say something about it.  In the same article, they also mentioned that Bekele has 250 of Ferritin and Gebrselassie 150.  

http://www.independent.co.uk/sport/general/athletics-bekele-ready-to-shred-the-record-books-6167676.html

I have not seen a Ferritin of 250 in natural conditions; a level that high is only attained by IV iron.  The majority of the Tour de France cyclists carry values above 500 because we know that transfusions and regular IV infusions take place.  Our athletes have the blood taken first thing in the morning during the recovery week.

I will continue speaking about education.  It does not matter how much we know about the subject.  How to educate people is the problem.  Stiglitz who was mentioned in the previous post speaks about it an interview:

http://finance.yahoo.com/blogs/daily-ticker/american-dream-myth-joseph-stiglitz-price-inequality-124338674.html

“Somebody at the top even if he does not do well he stays at the top…Somebody from the top who does not well at school, will do better than a low socioeconomic student who does well at school.  This says much about parents’ economy……if you are accepted to College.  You still have to go to the loops…if you do not go to the right High Schools you cannot do well on the exams… It is cascade of events.”

Athletic performance has to do with cultural education that goes hand in hand with values and subtle ways of cultural learning at home.  How to make things important for athletes depends on theirs experiences at home.  We all know that “how we learn to love” we learn it at home.  We have a saying in Spanish: “¿Cómo hacer que el burro toque la flauta?” “What to do so the donkey can play the flute?”  There is a post (Spanish) in this blog related to what it is mentioned above, December 12, 2011