Hi everyone, to follow on from my last post on nutritional deficiencies, we have an interview from the lovely Kirstin Maxwell, alumni member of EUOC! Thank you Kirstin for sharing!
When did you first realise something was up?
It was way back in 2009, my performances/sessions were just getting poorer and poorer and I fainted one day for no apparent reason. I put it down to exam stress and took some time off. Following this break, I ran a session and could not even complete it. At this point my parents were concerned and sent me to the doctors to get blood tests. I should not have been going backwards with the training I was doing, previous session times were impossible and I commented I was tired too often.
What were your initial thoughts when you found out you were deficient in iron and Vitamin B12? Did your recovery have an impact on your mental health?
Relief, both that it was not something more serious and that I had an answer to why things were going so badly. Initially it was hard because I had to reduce my training a lot and did not compete in some races because I had to focus on getting better. I missed out on selections which was hard to take. I am not the most patient person so felt frustrated and was definitely guilty of pushing things to far too soon. However, I slowly began to see improvements better results than I’d ever had followed which was exciting. I’ve definitely gone through lots of ups and downs emotionally especially when putting lots of work in with no results to show and at times felt a lack of support in my attempt to find answers.
How long did it take you to recover?
This is an interesting question, I don’t know if I have since I’ve never properly gotten to the bottom of the root cause (suspect it’s my stomach problems) but since late 2019 I’ve been in a really good place! Things went well for a while, then halfway round the JK long 2012 I suddenly felt so tired I couldn’t make my brain and legs work together. My head started spinning and I lost the feeling in my arms which then came back tingling, my hands went the same. I somehow made it to the finish and collapsed. I missed out on JWOC and spent the next few weeks dizzy and once again had to back off training. Everything continued to be up and down with problems and in 2015 I found out I was also B12 deficient and was given injections. I saw big initial improvements not just in my training but in life in general. I had more energy and was so much happier. A year later though things dropped again and I had to get my injections moved to a more regular frequency due to the volume of training I did. Then my iron dipped again in 2017, noticed after I fainted at work.
What did you do to recover? What were the steps?
After another funny turn at the JK in 2019 I was sick of trying so hard and my body failing that I spent a chunk of money to see Dr Andrew Murray at Fasic (a runner who knew about orienteering and had vast experience in elite sport). This was hugely beneficial. I finally felt like someone understood the level I was trying to compete and wanted to help me. I’ve always found it hard knowing if I was competing in another sport or in another national team for orienteering I’d have access to a lot more support like this instead of fighting with doctors/selectors etc. to listen. He wrote to my GP asking for specific test but then I took those results back to him to discuss. He said that iron often decreases with training load which is why my issues keep coming back and advised that I take iron until I stop competing (before I’ve been told it’s not good to take it all the time but due to my problems I’m not at risk of having too much!). My diet has always been good but I focus on taking my iron with vitamin C and away from dairy/caffeine. NHS Lothian stopped B12 injections for anyone who didn’t have specific type of the deficiency but the sport doctor helped ensure I did not see negative effects from this and I now take tablets instead which actually works better for me as I receive a more regular top up (alongside iron and, Vitamin D which he also recommended since it is difficult to get enough naturally in Scotland during the winter (HealthSpan Elite do batch tested for those in sport to ensure they are clean for anti-doping)). I ensure recovery is planned into training whether that’s easier weeks or rest days, it doesn’t matter what others do, I have to do what’s right for my body.
Advice you’d give to your younger self (pre-illness)?
Seeing stars every time you stand up is not ok! I know this might seem obvious but I became so used to it and only after starting B12 treatment this stopped. B12 deficiency if left un-treated can cause nerve problems so it’s important to treat these issues not just from a sporting perspective but general health.It’s ok to stop. If training is making you worse, you’re not doing it right. Your general health comes first!
Short piece of advice for someone who may think they have iron and/or B12 deficiency? What should they do?
Don’t’ give up, I’ve ran further than I ever thought I could and competed at a level I previously only dreamt of. Speak to a doctor, even better a sports doctor if possible. Explain that you aren’t a normal person (regardless of whether you’re orienteering socially or at elite level) so your blood test results need to be above satisfactory. If you’re not happy with the answers, don’t be scared to see someone else. Don’t just start popping pills, ask for a full blood test in case there’s something else going on but particularly the following (female satisfactory rage show with my sports doctor’s ideal number in bold).Haemoglobin (can indicate iron deficiency anaemia): (115-160) >130Ferritin (iron stores): (15-200) > 50B12: (180-2000) >200
Other important information you would like to share?
Tiredness from a B12/iron deficiency isn’t the same as from training hard it’s the feeling of being unable to go on, drained and feeling that everything including day to day life including socialising is a chore. Symptoms I’ve experienced – gasping sounding breathing, breathlessness, fuzzy head/seeing stars, tingling in hands/feet often, unexplained tiredness, fainting, pale/drained complexion, excessive moulting of hair, bleeding gums. For some people improving their diet can help (leafy green veg, meat/fish, dairy, beans, nuts, fortified bread/cereals). Deficiencies are very common in female runners due to amongst other things periods but can still affect men too. If you are vegan/veggie you may need to think up supplementing anyway there’s less options for B12 in diet