Low hematocrit - Medical thoughts?

So, I had a work-sponsored “health and wellness” test and just got the results which are incredibly thorough. On the plus side, I am very healthy, so no worries there.

There were four items that came out below reference range, nothing bad, but not good for my illusions of being a genetic wunderkind.

Any meds out there with thoughts on whether this is significant, and if there is anything I can do to raise them apart from spending my life’s savings on EPO (jk for the hyper-reactive of you out there)

White blood cells 4.60 (4.8-10.8) THO/mm3
Red blood cells 4.52 (4.7-6.10) MIL/mm3
Hemoglobin 13.5 (14-18) gm/dl
Hematocrit 40.5 (42-52) %

Iron levels are fine, everything else is fine. Thoughts?

procrit or epogen
.

Are you male or female? Vegetarian or not?

You can win races with a Hcrit in that level. I doubt you will be given a TUE by the WADA. I would not worry much but give it a check.
Sergio

Male, definitely not veggie
.

If you are really concerned go to your doc and get your ferritin levels checked. I’m not a medical professional, but I had trouble with anemia. I don’t know what my Hemoatcrit number was, but my Hemoglobin was a 9 and ferritin level was a 4. I felt super sluggish, but was still able to train. If you have anemia problem you would probably feel it.

I’m not a doc, but I’ve had a little experience dealing with this issue:
For many athletes that I coached who lived at altitude, I had good luck with natural supplements like Hemaplex or EP-No. I was consistently able to get a 2-3 point Hct increase after 1-3 months. The difference from normal iron supplementation is how the body converts elemental iron (as ingredient: ferrous chelate or similar) to the functional heme group of a red blood cell. Though you said you have normal serum ferritin levels, your body may be having trouble converting that into functioning RBCs. I’ll admit my knowledge is pretty limited on the processes involved that might limit that conversion. The iron in those supplements I listed above have a more bioavailable, albeit less potent, form of iron. Rather than putting elemental iron directly in the pills, they use dried beet root, dessicated liver, or some other naturally occurring source of iron. My theory is that the iron found in these is more readily converted for use with the heme group. I’m sure if you dig deep enough you could find confirmation or debunking of that theory. If you find something that can bring up the Hct levels, the Hgb / RBC should come up with it.

The best option would be to talk to your MD/DO about these Hct levels. They might normally not worry too much about that level, but you can pretty easily make a case as an athlete. At 40%, you are definitely getting held back from optimum levels. As an aerobic athlete, your performance is directly related to that number, and you would do well to get it up. Your doc should at least be somewhat familiar with the status of anything he may recommend with respect to USADA/WADA regulations. To be sure, check the Drug Reference Online ( www.globaldro.com). It’s a quick & easy go/no-go guide to pretty much any controlled substance out there.

Keep us informed with your progress. Good luck!

Thank you, I appreciate your thoughts. I’ll look into it and let you know what I find.

Had Hem-values in your range - measured in between my PR IM race and PR Marathon race (I won this local Marathon).

The doc did some more tests. The final conclusion (for me) was “sports anemia” - no real lack of iron, just a high increase in blood volume (bringing the % for “dry stuff” a bit down.)

Hypervolemia.

Go for a run, then have it checked. It’ll be right in the middle of the normal ranges.

BTW, what are the rest of the indices? MCV, MCHC, MCH?

FF

Hypervolemia.

Go for a run, then have it checked. It’ll be right in the middle of the normal ranges.

BTW, what are the rest of the indices? MCV, MCHC, MCH?

FF

MVC 89.6 (80-94)
MCH 29.9 (27-33)
MCHC 33.3 (32-36)
Iron 90 (33-180)

Thanks for the insight. Overall, my values for everything run on the low side of the referenc range.

When I had my blood checked my iron values were at the very high end of the spectrum. That was a few months after taking some EP NO. The one thing I would suggest is if you get the EP NO to buy the high iron concentration version (30mg/serving) and only taking 1 pill/day instead of 3. That way it will last 3 months instead of one month as opposed to buying the lower iron concentration of 10mg for the same price that will only last 1 month. I usually take a regular vitamin with 10mg of iron on a semi-regular basis then will take another 10mg of EP-NO/day in the months leading to peak races. So far I have gotten my HcT > 50 doing this.

Your cell sizes and density are all well within normal limits.

The simple fact is your H/H (Hemaglobin/Hematocrit) is not that low. Think of it this way. Get a glass of correctly mixed Koolaide. Pour some water in the cup. That’s you. Your normal when mixed right, but when you have on some extra fluid on board, your on the diluted side.

With a 13.9 hemoglobin I doubt your symptomatic. Therefore treating something that is not a problem, is a problem.

FF

I was as low as 36.8 Had a few tests under 39 and finally solved my ‘problem’ with proper iron supplementation. By proper I mean quality iron taken with other supplements necessary for absorption as well as making sure nothing in my stomach hindered absorption.

I got my crit up to 41 and noticed a profound difference in quality of life and athletic peformance. Full story below.

https://sites.google.com/site/passivetechnique/passive-technique-blog/breakingthroughhowanathletetookhis40kttfrom5531to5139in1-year

Do you drink a lot of tea? The tannins in tea inhibit the uptake of iron into the system. I had this problem (drank about a gallon of ice tea a day). Quit the tea and my iron levels were all normal in a couple of months.

Interesting, lots of good suggestions here. Not a big tea drinker, so not that either.

Having a nutritionist look at it, as well as checking out the hypervolemia. That shit sounds scary!

I have a job that requires an annual physical. I routinely measure low HCT levels, also live at high altitude. After researching it a little, I finally came to the conclusion that highly trained athletes can have higher blood volumes (excess plasma), which can mask itself as low HCT levels. You are probably fine. Anyway, I perform well, so I decided I wasn’t going to worry about it, although I do supplement with iron when I am racing. Don’t know if it helps or not.

On a side note, it was recommended that my personal physician look into it, which lead to a colonoscopy (at age 40), that found a pre-cancerous polyp. Funny how one thing sometimes leads to something completely different.

I have a job that requires an annual physical. I routinely measure low HCT levels, also live at high altitude. After researching it a little, I finally came to the conclusion that highly trained athletes can have higher blood volumes (excess plasma), which can mask itself as low HCT levels. You are probably fine. Anyway, I perform well, so I decided I wasn’t going to worry about it, although I do supplement with iron when I am racing. Don’t know if it helps or not.

On a side note, it was recommended that my personal physician look into it, which lead to a colonoscopy (at age 40), that found a pre-cancerous polyp. Funny how one thing sometimes leads to something completely different.

I’d say you are likely right on. Felt like shit the two cx races the weekend before the test, but I generally haven’t had an issue with performance and some rest afterwards was back to a typical level. I am working through an injury at the moment, so I am not able to train as much as I was. Wondering if this could be a contributing factor.

Working on researching some of the supplements mentioned above. I appreciate your feedback though, looking down the barrel of a moon river moment at 37 myself…

Interesting. What is your source of info on nutrition and iron absorption?

I just used Google. I pulled from many different sources.

In a nutshell - Iron Bi-glycinate works. Ferrous Sulfate is crap. Taken with Vit C and sublingual B-12. I took it all on an empty stomach to avoid any absorption issues. I have a strong stomach. Some can’t tolerate Iron on an empty stomach but if you can, you can really simplify things. Caffeine and alcohol are big no-nos with Iron. There are others as well. That’s why empty stomach is best.