Running with Iron Deficiency Anaemia: Conquering a Half Marathon

How I managed Iron Deficiency Anaemia and ran The Great North Run

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Running a half marathon is no easy feat, requiring dedication, discipline, and perseverance. But what if you’re also managing iron deficiency anaemia? Don’t fret! With the right approach and proper care, you can still lace up your running shoes and conquer that finish line.

In this blog post, we’ll explore the challenges I faced by running Middlesbrough 10k Race and The great North Run with iron deficiency anaemia. I have provided helpful tips I took onboard to ensure a successful half marathon experience.

Image: Myself (Aimee, Left) and good friend Katrina (Right) before Middlesbrough 10km run September 2023 – precursor to running The Great North Run!

Symptons, Diagnosis and Cause

I was diagnosed with Iron deficiency anaemia in January 2021. Since then, I have had a battle for over 2 years to get my iron levels up. I went to the doctors after months of being struck down with migraines, dizziness and lethargy. My Ferritin levels were 3.7.

The average for a healthy female my age should be 100, so this was quite a shock. It was a sign something was not right. I started taking iron supplements, but had not found the root cause. After a while, it was suggested I should cut out gluten and almost overnight I instantly felt better. However, my time of the month would still wipe me out. It was a long battle to get back to 100%. Which I am still working on.

Every month gets better, but some things with regards to exercise and running have set me back. With some research, I have managed to work towards my goals and managing the condition.

Sometimes, we have to be our own hero and researcher to find out what works for us. The GP Practice could only help so far with blood tests and prescriptions. The rest I had to research for myself. Being so anaemic really affected my mental and physical health. However, with tips and pointers from those with similar stories to me- I have found a good balance.

Big thank you to the ladies at More Than A Run!

I would not have completed the run without the support of More Than A Run CIC.
The Tuesday running group supported myself and two other ladies running. Run Leader Pam also joined us. The weather was against us, with scorching sun at the beginning and torrential rain at the end, but we all made it!

Big shout out to volunteers Julie and Carole who came and supported us, we would have been lost without their support. More Than a Run CIC do lots across Teesside, check them out if you would like support to start running.

I hope this blog inspires those with the condition to keep active . Also to searching for answers and what works for them to cure, or manage their anaemia.

Understanding Iron Deficiency Anemia

Iron deficiency anaemia occurs when your body lacks enough iron to produce sufficient red blood cells. This results in reduced oxygen-carrying capacity. This can lead to fatigue, weakness, and decreased endurance – not exactly ideal for long-distance running. However, with appropriate management, individuals with this condition can still pursue their running goals.

There are many different types of anaemia, with iron-deficiency anaemia being the most common. Especially in who experience periods affecting levels.

I found it difficult, when trying to manage symptoms and get iron and ferritin levels up. Especially when it was my time of the month. This is due to having heavy periods, which would totally wipe me out. I felt I was on a losing battle, but I persevered and managed to fight the curve. Finding a good balance for what works for me – to keep my physical and mental health in check, was key in success.

Managing symptoms and
raising iron levels

The Impact of Foot Strike Hemolysis on Runners, Particularly Female Runners

One thing I found when I was training to run a half marathon, I would be OK up until 10-14km. Greater than 14km, I would feel really unwell and start to get symptoms of anaemia. I would experience headaches and nausea shortly afterwards that would last for a day or two.

Upon some research – I fell upon a condition that affects many runners who run longer distances. Foot Strike Hemolysis.

What is Foot Strike Hemolysis?

Foot strike haemolysis, also known as “march haemoglobinuria,” is a condition characterized by the destruction of red blood cells during prolonged or intense physical activity, such as running. The repetitive impact of foot strikes on hard surfaces can cause trauma to the red blood cells, leading to their rupture and release of haemoglobin into the bloodstream.

Impact of menstruation

For those who’s ‘time of the month’ affects their iron levels- be aware that this may be a time to make sure you are on top form hydrating and supplementing. For me, going out for long runs when on my period, would wipe me out and make me feel unwell for days after. I always make sure to give myself that extra bit of TLC at this time.

Consequences and symptoms

When we run longer distances and red blood cells rupture and break apart. The released haemoglobin from damaged bloodcells can lead to various symptoms and health concerns. Some common consequences of foot strike hemolysis include:

  1. Anaemia: The destruction of red blood cells can result in anaemia. Ruptured blood cells reduce the ability of blood cells to carry oxygen efficiently. Anaemia can lead to fatigue, weakness, and decreased athletic performance. It can also lead to dizziness, headaches and migraines.

    With my anaemia symptoms – I always suffer dizziness, headaches and nausea. Sometimes migraines – which will lead to sickness.
  2. Muscle and Joint Pain: Foot strike hemolysis may contribute to increased muscle soreness and joint pain. This is due to the inflammatory response triggered by the presence of hemoglobin not bound to red blood cells in the blood stream.

    Muscle and joint pain is common in runners, especially as we start to go further and push for personal bests (PB’s). However, if it feels unbalanced – it might be for these reasons.

Prevention and Management when running those longer distances.

To minimize the risk of foot strike hemolysis, especially for female runners, the following measures can be helpful:

Training and Technique

  1. Proper Running Technique: Focusing on running form and adopting a midfoot or forefoot strike pattern may help reduce the impact on the feet, lowering the risk of hemolysis.
  2. Gradual Training Progression: Gradually increasing running intensity and mileage allows the body to adapt and minimize the risk of excessive foot strikes.

    I have found using an app to build up to 5km initially, then 10km finally 21km has really helped with training and building things up gradually.

Hydration & Monitoring

  1. Adequate Hydration: Staying properly hydrated during runs can help maintain blood volume and reduce the concentration of components that contribute to hemolysis.

    This is really interesting, as I know hydrating is really important, but I didn’t realise how much it can support with reducing anaemia symptoms till researching.
  2. Routine Monitoring: Regular blood tests can help identify early signs of anemia or hemolysis, allowing for prompt intervention. If suffering any symptoms, it is recommended you get checked out as soon as possible.

    I let myself suffer for too long before getting my bloods checked. By then, my Ferritin was at 3.7(normal range 100!) – sometimes we can feel a burden or fussing over nothing, but when Iron Deficiency Anemia kicks in, it can really affect our quality of life and take months to reverse. So make sure to put yourself, your health and wellbeing first. Doctor’s are there to help and support us.

I improved when following the advice above.

It is important to understanding and learn about the condition. Especially its symptoms. Taking appropriate preventive measures can help minimize the associated risks and ensure a healthier running experience for all.

Since noticing symptoms, I have modified my practice using some of the techniques above on longer runs. I managed to run The Great North Run for Teesside Hospice and not feel any symptoms after. This came as a shock. I was certain I would feel some symptoms as it was the longest run I have ever done.

Consult with a Healthcare Professional

Before embarking on your half marathon journey, it’s crucial to consult with a healthcare professional. Preferably, a sports doctor or registered dietitian. They will assess your specific condition, provide personalized advice, and help you develop a suitable training and nutrition plan.

Nutrition Strategies for Runners with Iron Deficiency Anemia

Proper nutrition plays a vital role in managing iron deficiency anemia, especially for runners. Here are some key strategies to consider:

  1. Iron-Rich Foods: Incorporate iron-rich foods into your diet, such as lean red meat, poultry, fish, spinach, lentils, and fortified cereals. Combining these with vitamin C-rich foods (like oranges or bell peppers) can enhance iron absorption. Non-heme iron (from plant sources) needs Ascorbic Acid (Vitamin C) to absorb properly. The body can absorb heme iron (from meat sources) much more readily.
  2. Iron Supplements: Your healthcare professional may recommend iron supplements to help increase your iron levels. Take them as prescribed and be mindful of any potential side effects.

    It is recommended if taking non-heme iron supplements, to do so an hour before eating, or 2 hours after eating. It is also recommended to take it with a glass of orange juice, as the Vitamin C helps with absorption.
  3. Balanced Diet: Ensure your diet includes a good balance of carbohydrates, proteins, and healthy fats to support overall performance when running. Diet is key!

All of these tips helped me complete The Great North Run.

I hope some of these tips will help those who are suffering with Iron-Deficiency Anaemia. There are many topics to be explored with a health care professional to help you feel fitter, healthier and happier!

We would love to hear your experiences, let us know in the comments below!

Aimee is a Gentle Yoga and Meditation teacher in Middlesbrough.

Aimee is also managing director of AMALAwellness – a grass-roots community interest company that offers Gentle Yoga, Tai Chi, Meditation and Chair Yoga & Exercise across Teesside.

To see what we offer across Teesside, visit

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