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Sep 2023
2:40pm, 5 Sep 2023
110,038 posts
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Hanneke
Larkim, Perimenopause can cause excessive monthly bleeding that can easily cause her issues. Also if low on B12, you will struggle to produce enough hemoglobin! Most peri- and post-menopausal women are low on B12, especially vegetarians, as the only bio-available source of B12 is in animal protein!
I myself supplement B12 daily and tend to have to top up Iron once a year by taking Floradix for a couple of months.
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Sep 2023
2:44pm, 5 Sep 2023
21,910 posts
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larkim
Yes, she's mentioned that, though not noticed any real change in her monthly bleeding. Not that would justify the massive drop in iron. And she is also an omnivore. She's definitely odd by being entirely normal despite the low iron.
She's got some checks soon which will see whether the "store" has gone up to match the improved blood iron levels. Her haemoglobin was v low too, but that restored to normal values pretty quickly on the iron tablets.
She basically went from a 32min parkrunner to a 26min parkrunner in a few months through the iron / B12 stuff. (And then got injured!)
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Sep 2023
2:58pm, 5 Sep 2023
2,123 posts
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auburnette
I think what I've learnt is you shouldn't underestimate how much iron you can lose if you're menstruating and exercising. My husband also tested iron and his serum ferritin was 400 - if anything almost too high - and we eat a similar diet.
For me contributing factors seem to have been:
Menstruation (nothing dramatic!)
Exercise - footstrike haemolysis and also through sweat loss
Iron binding foods in the diet - coffee, tea and I sometimes drink milk after dinner. Calcium inhibits iron absorption
Low vitamin D - apparently low vitamin D increases hepcidin expression
My B12 and B6 were normal. Other than one week of feeling generally exhausted I had no symptoms of iron depletion/deficiency except when I was running. When running, the things I noticed were:
Deep fatigue feeling even on easy runs and in weeks when I should have felt fresh
Slower pace for the same heart rate - I run mostly by effort so I just slowed down
Couldnt seem to get into zone 5 properly. Like just lacked an extra gear.
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Sep 2023
3:23pm, 5 Sep 2023
110,039 posts
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Hanneke
Some people, like myself, actually function perfectly fine on low iron... I was an extreme endurance athlete and that contributed to it. Plus I have always had seriously heavy periods. My situation did not improve post menopause.
My GP put it down to "one of those things we cannot explain" you just function like that, let's not worry about it 
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11 Mar
9:58am, 11 Mar 2024
2,261 posts
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auburnette
Wanted to share this interesting data on the effect of my anaemia (which now seems resolved)
The first chart shows my weekly mileage over a year, 3 X marathon builds. The second chart shows average pace. The third chart shows beats per mile.
While there are some confounding factors (the second marathon was run in the summer and therefore training in the heat and with higher elevation gain) it's striking how my pace and beats per mile worsened in the period where I was struggling with anaemia.
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