Training log - Week ending 09/06/2020

This week was 38 miles of running and 39 "miles" of pool-running -- training log is here. 

When last we left off, I had bloodwork pointing towards a folate deficiency and a pending appointment with my primary care doctor to discuss that round of bloodwork plus some stuff he had run.

As it turned out, his bloodwork also showed a normal CBC with no anemia, a significant folate deficiency, and normal vitamin D.  He had also run a full iron panel (not just ferritin) which came back fine, and a test for B12 which was above the reference range (surprising, since I had expected it to be below).

So...he prescribed me a folic acid supplement (1mg, if you're interested).  Which I eagerly started immediately.   (I'm also following up with some other doctors to confirm that the cause of this deficiency is indeed my ulcerative colitis.)

[BTW - important to note here that it can be very risky to decide on your own that you are deficient in something and start supplementing, even if you have bloodwork to support that.  You can go very wrong with supplements, even if they are water-soluable.  For example, in my case it was really important to check the B12 levels before starting folic acid supplements - had I been B12 deficient, supplementing with folic acid could have resulted in permanent neurologic damage.  Always check with a health professional before supplementing.]

 Of course, the big question on my mind was: how long until I feel better?  The short answer is: it depends and my primary care doctor didn't give me a concrete answer - I'm guessing because he couldn't.  The longer answer is in the bracketed paragraph below.

[longer answer, based on my amateurish reading of medical journals:  folate is involved in many many processes in the human body.  Your body uses it to build healthy red blood cells (RBCs) that are the right size.  Folate also plays a role in many other processes related to both energy generation and DNA replication.

Your normal human body turns over its red blood cells every 3-4 months.  Meaning that if you have damaged red blood cells, it will take that long to get the bad red blood cells completely replaced with better ones.  And while I'm not anemic (so I don't need to wait 3-4 months to fix that issue), based on my very low serum folate it's pretty certain that my otherwise normal blood cells may not have as much folate in them as they should.  (folate is stored in red blood cells - you can measure that level by testing RBC folate. however serum folate is usually a decent proxy for RBC folate).  If that lack of folate means that the red blood cells don't work as well as they should, then I'll need to wait for that to get fixed.

However, also interesting to note that runners are apparently not normal humans.  In fact, endurance athletes, especially runners, tend to turn over their blood cells much much faster.  This is because our vigorous efforts tend to destroy red blood cells before their time, either from being damaged by being in the wrong place at the wrong time (in the sole of the foot during footstrike) or from weathering the turbulence of travelling very quickly through capillaries.  So...our red blood cells get replaced much quicker.  Which has the added benefit of the average age of our red blood cells being younger, which means they do their job better.

So maybe my red blood cells will be replaced with new ones quicker - meaning any effect from not having adequate folate in my current RBCs will be fixed quicker.

And as for the other processes that are not directly dependent on RBCs - hopefully if they haven't been working well, they'll start working better as soon as they have access to enough folate.

Again, no doctor has told me any of this - it's just me and my internet connection.  Take all of the above with a big heaping dose of sodium.

Also worth noting: hematology is fascinating.  I keep wondering if I missed my calling.  And then I run past some bio-chem chart and I confirm that law school was the right choice.]

The good news is that I did start feeling better fairly soon after starting the folic acid supplement.  Friday's attempt at a hill workout felt much much better than Tuesday's even though Friday was warmer and more humid.  Tuesday was before starting folic acid supplementation; Friday was after.  And while Sunday's not-quite-a-long-run wasn't great, it still felt like a big jump forward.

I've also noted a few other things - some nerve pain in my left leg seems to be improving, while the lingering mild nerve pain in my right ankle (which has been there for a long time) is gone.  Yoga classes seem a lot shorter than they used to, and I'm no longer squinting through my reading glasses.  I was about to go see the eye doctor and get my eyes checked, but I'm now thinking there's no need.  

Here's hoping to continued improvement.  I supplemented my minimal land running this week with a lot of pool-running to keep my volume up so that I can come back fairly easily.

Dailies 

Monday: 7 "miles" of pool-running and upper body weights/core. Foam rolling at night.

Tuesday: 7 miles, with two Stafford Street hill repeats (370m hill at 5% incline) in 1:54 and 1:56 (just over 3 minutes jog down after each). Followed with 40 minutes of pool-running and streaming yoga.  Foam rolling at night.

;

Wednesday: 4 miles aerobic (9:36), drills, and 7 "miles" of pool-running followed by streaming yoga. Foam rolling at night.

Thursday:  7 "miles" of pool-running and upper body weights/core. Foam rolling at night.

Friday: 8 miles, with six Stafford Street hill repeats (370m hill at 5% incline) in 1:46, 1:44, 1:43, 1:41, 1:38, 1:35 (just over 3 minutes jog down after each).  Followed with 4 "miles" pool-running and some leg strength work. Foam rolling at night.

Saturday: 7 miles very easy (9:31), streaming yoga, and 5 "miles" pool-running.  Foam rolling in evening.

Sunday:  12 miles progressive (9:41/9:14/9:17/9:33/8:43/8:41/8:24/8:09/8:08/7:53/7:45/7:36), and then some leg strengthwork and streaming yoga.  Doubled back with 5 "miles" pool-running.  Foam rolling in afternoon.