Over the last couple of months, my sleep quality has drastically declined. I’ve been waking up every couple of hours. Thankfully, I have a fabulous family doctor, who identified a cause that I was completely unaware of: my ferritin levels.
Ferritin is measurement of the body’s storage of iron. A low ferritin level indicates iron deficiency. This is different than iron deficiency anemia. In iron deficiency anemia, hemoglobin levels and RBC lab values will also be affected. The World Health Organization uses a cut off value of a ferritin less than 15 mcg/L to classify iron deficiency anemia. However, for athletes, aiming for ferritin levels greater than 30 mcg/L is more standard practice. My ferritin level was 8 mcg/L. I looked back on my blood work to 2016, and the highest ferritin measurement that I could find was 22 mcg/L.
Low ferritin levels, even before anemia develops, have been shown to negatively impact athletic performance. The negative impacts go beyond athletic performance to even influencing cognitive function. What I seem to be experiencing as a side effect of my low ferritin levels is “Restless Leg Syndrome.” This is characterized by a need to move legs during sleep. My doctor believes that this is what is constantly waking me up during the night. Sure enough, I delved into the research and Restless Leg Syndrome is more severe with a ferritin less than 45-50 mcg/L. When I wake up, I do notice it’s because I need to move.
I’m not training for any races, so instead of a running goal, I have decided that my summer goal will be to increase my ferritin levels before I get it retested in September. I didn’t realize what a bad job I was doing in the iron department. Here is my ferritin raising plan:
- Watch my tea and coffee consumption: Tea and coffee (even decaf) contain polyphenols and tannins that reduce our body’s ability to absorb iron. I drink coffee and tea constantly throughout the day. Even if I was consuming large amounts of iron, I doubt that I would be absorbing much of it. I’ve decided that except for breakfast (Sorry.. I need my coffee), I’m going to wait 1 hour before and after meals to drink tea or coffee in order to allow for more iron absorption.
- Watch my calcium intake: I also love my dairy products. I have no problem getting my 2 milk and alternative servings per day since I’m all about bone health. However, I seemed to be going a tad overboard. When I looked at my diet, I realized that I’m getting more like 4-5 milk and alternative servings per day. While I’ll definitely still aim for 2 milk and alternative servings per day, I’m going to replace a couple of these servings with iron rich foods
- Include a high iron food with each meal: Red meats are typically the first thing that comes to mind when we think iron. This is certainly true. Red meats contain heme iron that is readily absorbed by the body. However, some plant sources also contain good amounts of iron. For instance, pumpkin seeds, chickpeas, breakfast cereals and tofu are all really good sources of non-heme iron. This type of iron isn’t absorbed as well, but we can increase its absorption by pairing it with high vitamin C foods. For instance, I’m switching my night time snack of Greek yogurt to All Bran cereal and berries and am going to make sweet-potato hummus for my lunch this week.
- Take an iron supplement: It is never a good idea to take an iron supplement without first getting your blood worked checked. Taking excess iron can be dangerous for your health. If your ferritin stores are low, and a health care provider recommends that you take a supplement, take it with a source of vitamin C to enhance absorption. You should also take it away from exercise, which decreases absorption, and on an empty stomach. For myself, the best time for me to take an iron supplement is around 9-10 am.
I’m ready to take my iron intake to a whole new level. My main motivation is to increase my sleep quality. If you haven’t got your blood work done in a while, and you’re concerned about your iron levels, it may be worth asking your family doctor for a lab requisition.