Thursday, February 19, 2015

Blood(y) Ultras

As a type 1 diabetic I have regular blood tests. Every 6 months in
fact. They check a load of things and I normally get feedback on my
HBA1c (http://www.diabetes.co.uk/what-is-hba1c.html) and my
cholesterol. Everything else presumably at normal levels and so not
worthy of mention.

This time was different, I had low iron, low platelet count and higher
levels of bilirubin in my liver. I am seeing the doctor in the morning
to get clarification on each of these and to determine what I need to
be doing and should be doing to redress the balance.

In the meantime I have done some internet research and they are all,
probably, linked. The root cause is my training regimen but it also
goes further than that...

Iron
Found in leafy greens (kale, spinach, cabbage etc) and meat red meat.
Meat is the top of the list, actually liver is top of the list but as
I eat neither it's a bit of a problem. I do regularly eat my greens, I
also eat a lot of chick peas. I am assuming that this is not enough to
sustain the amount of run training that I do. Not that the volume is
that massive but perhaps combined with my age and diet it is.

Since having this identified I have been taking a supplement to
restore my levels which I will cease after a day or two.

Combine this with damaged red blood cells and the issue is compounded.

Red Blood Cells
These live, normally, for around 120 days in the body. After which
they die but as they have been alive for 120days the body has time to
replenish. During endurance training and running particularly they can
become damaged and die prematurely. As the body has not had time to
replenish then the count is reduced. This contributes to the lack of
iron.

(http://www.medscape.com/viewarticle/523124_4)
(http://www.ncbi.nlm.nih.gov/pubmed/7740249)

Bilirubin
I have copied this definition from the website
(http://www.patient.co.uk/health/liver-function-tests). The second
bullet near the end of the passage is relevant...

This chemical gives bile its yellow/green colour. A high level of
bilirubin in your blood will make you jaundiced ('yellow'). Bilirubin
is made from haemoglobin. Haemoglobin is a chemical in red blood cells
that is released when the red blood cells break down. Liver cells take
in bilirubin and attach sugar molecules to it. This is then called
'conjugated' bilirubin which is passed into the bile ducts.
> A raised blood level of 'conjugated' bilirubin occurs in various liver and bile duct conditions. It is particularly high if the flow of bile is blocked. For example, by a gallstone stuck in the common bile duct, or by a tumour in the pancreas. It can also be raised with hepatitis, liver injury, or long-term alcohol abuse.
> A raised level of 'unconjugated' bilirubin occurs when there is excessive breakdown of red blood cells - for example, in haemolytic anaemia.

All of which, if correct, indicates that the issues should not be
anything serious to worry about as the root cause is understood.
Obviously I'm no doctor and may have interpreted things to
simplistically. I'll find out tomorrow.

This does perhaps raise two questions....actually three questions...
1. Is a vegetarian diet good for endurance runners?
2. Is ultra running any good for you?
3. Should I switch back from IPA to drinking Guinness again?