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I have struggled with iron deficiency and anemia basically since I started running. I have always been a healthy eater eating lots of fruits and vegetables and anything else I was offered; I have never been picky either. I remember going for a physical as a young kid, probably my fifth grade physical, and being slightly anemic. My sister on the other hand, whose answer to the doctor's question of, "Do you eat vegetables?" was, "Yes, raisins," had perfect lab results. It seemed ironic to me the kid who ate exactly what she was supposed to was anemic, and the chicken fingers and French fries feen got a clean bill of health.

As I became more competitive in high school, I started to feel the effects of low iron counts. I couldn't finish quarter workouts and watched over 90 other runners pass me at the 1/2 mile to go of the conference race despite my fitness levels. In college I was frustrated to find that I was still anemic despite eating the prescribed red meat and taking iron supplements. I just crossed the non-anemic barrier only by consuming two pills daily. Just last summer I was feeling light-headed often, and once again, lo and behold, pronounced slightly anemic!

The happy ending to this story is that I haven't been anemic since. Soon there after, I chose to venture into the wheat-free zone. After spending many nights doubled over in pain or in the bathroom with gastrointestinal discomfort to say the least, I thought it was worth a try. After one week of avoiding my standard cereal, sandwich, pasta diet, I was symptom free. And one year later, my hematocrit is "like a man's," according to my doctor. Simply by eliminating wheat from my diet, I improved the absorption of the iron. I apparently have had a wheat sensitivity for years, contributing to my chronic anemia.

I do not have Celiac and I really am not allergic to wheat. It is more of an intolerance, or a sensitivity. Whenever I eat wheat, antibodies are released to protect against the foreign invader, wheat. A chain inflammatory reaction occurs, causing absorbance to be sacrificed and my gut to be swollen. When nutrients are not absorbed properly, vitamin and mineral deficiencies result, hence the anemia. If you have had multiple bouts of anemia and follow an iron-rich diet, consider your ability to absorb the nutrient. Look for common culprits in your diet - wheat, milk, and eggs as well as nuts, shellfish and fish, and other gluten containing grains are the most likely allergies and sensitivities to food. Other symptoms of food sensitivities may include skin problems (acne, eczema), poor immune system, chronic congestion or sinus infections, headaches or migraines, or frequent cravings or mood swings.

The Science Behind It

The hemoglobin within a red blood cell is responsible for carrying iron. Oxygen then attaches to the iron. Anemia can result from insufficient RBCs, not enough hemoglobin, or not enough iron. A hemoglobin molecule has four protein, or globulin, subunits, each with a heme group and iron atom in the center. The iron atom combines with oxygen molecules.

Oxygen binds to hemoglobin in a cooperative manner, meaning after one oxygen molecule binds, the structure changes shape, making it easier for other oxygen molecules to bind.

Fe3+ , or the ferric form of iron, cannot bind oxygen. It must first be oxidized, so it is best to take ferrous (Fe2+) form.

How much iron do we need? The Recommended Dietary Allowance (RDA) is 8 mg for adult males and 18 mg for adult females. Because of the higher levels of red blood cell destruction in runners, we can get away with supplementing with 100% of the RDA even without deficiency. Iron should be taken in the more absorbable ferrous state. There are three forms of supplemental iron - ferrous fumerate, ferrous sulfate, and ferrous gluconate. Ferrous fumerate has the highest percentage (33%) of elemental iron, meaning it is the best absorbed. Ferrous sulfate and ferrous gluconate have 20% and 12%, respectively.

If taking more than one pill to supplement, it is best to split up the pills - only a set amount of iron is absorbed at one time. When hemoglobin levels are below normal, physicians often measure serum ferritin, the storage form of iron as well.