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McKale is a dietician, runner, and has a big passion for iron. Iron is a major component of hemoglobin, a type of protein in red blood cells that carries oxygen to the body. Today, McKale talks about the role of iron, why it is important for runners and what you should do if deficient. Throughout the interview, Mckale talks about: Is a drop in energy levels during certain parts of the menstrual cycle caused by low iron? Does a runner require a diet higher in iron? Are infusions and supplements necessary? And are there any dangers? Check out McKale on Twitter @McKaleDavis Or ask her a question at mckale.montgomery@okstate.edu Run Smarter YOUTUBE Channel Become a patron! Receive Run Smarter Emails Book a FREE Injury chat with Brodie Run Smarter App IOS or Android Podcast Facebook group Run Smarter Course with code 'PODCAST' for 3-day free trial.
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On today's episode, the importance of iron for runners with Mikhail Montcomery. Welcome to the Run Smarter podcast. The podcast helping you overcome your current and future running injuries by educating and transforming you into a healthier, stronger, smarter runner. If you're like me, running is life. But more often than not, injuries disrupt this lifestyle. And once you are injured, you're looking for answers and met with bad advice and conflicting messages circulating the running community. The world shouldn't be like this. You deserve to run injury free and have access to the right information. That's why I've made it my mission, to bring clarity and control to every runner. My name is Brody Sharp. a former chronic injury sufferer and your podcast host. I am excited that you have found this podcast and by default become the Run Smarter Scholar. So let's work together to overcome your injury, restore your confidence and start spreading the right information back into your running community. So let's begin today's lesson. It has been a long time coming, but the Run Smarter Book is now available for you to purchase. It's on Amazon. It has a Kindle version and it has a paperback version. I am still working on the audio book. I have decided to start editing it all myself and takes a really long time. So as of today, which is Friday, the 5th of August, I am up to chapter seven. I'll have to edit chapter seven today and I've got 20 chapters to cover. So That might be out in a couple of weeks. I do know that some runners have said they just like listening. to content rather than reading. And so that's why you're listening to this podcast. And so that's why I feel the need to have that audio book version that's out there. Please let me know what you think I will put onto social media. Well, at the time of recording yesterday, I would have released a post on Facebook or on Instagram asking, um, if you're interested in purchasing the book, please like leave a comment, like raise some excitement. Let me know if you're excited about the book or if you've already purchased the book, if it's on its way. It would be a lot to me if we can see how much interest and how excited you are to get it. Um, I have what they usually do and what I have ordered. I think I said this last episode, but there is a, um, once you submit it to Amazon, you can then send yourself a proof copy, which is kind of like just making sure that the cover and all the, I guess, margins and that sort of stuff is in place and everything looks pretty much good to go. So I ordered that. Everything looks great with the pre-order. I haven't. received my author copies yet. Usually with Amazon, you can order author copies, which means that, you know, I can get them delivered to my house at pretty much the price of printing and I've ordered a couple and they haven't arrived yet. They're meant to arrive next week, but I'll assume that it's all going well. If I had the patience to wait another week and deliver this information to you next week, maybe I'd be a little bit more confident that the original would be. Ready to go. I'm just going to assume the original is ready to go, not wait for those copies to arrive before I tell you to go buy it because it is on Amazon now. So you can search run smarter. We'll have the, the lovely, uh, podcast logo on the front of book, you'll say Brody Sharp. And yeah, like I said, order the copy, whether it's paperback or Kindle and. Let me know. I'd love to hear from you. Today we have a two-parter. I'm talking to a Mikhail Montgomery, who is a dietitian. I heard her on the running explained podcast talking about iron. And I thought it's great. Fantastic. Haven't talked about that before. Love her level of knowledge and her enthusiasm. And she's a runner as well, which she'll talk about at the, the start of our conversation and with. These particular nutrition topics, I do like to open the floor to patrons to submit their questions. And so we start off with a few of my questions, just asking about the role of iron and what it is. Why is it so important to athletic performance and for runners in general? And we touch on just, I guess, setting the scene for the next iron based questions to then answer which were submitted by the patrons. Thank you to all those patrons that have submitted questions. Um, I've kind of organized it that the first six or so questions, which takes up part one of the episode to be mainly around iron, uh, but then I also opened up the floor for the patrons to submit questions to just generic dietitian questions as well, cause I know that that's so popular. So while there is a bit of overlapping here and there part two, which will be out next week, um, is. covering the remainder of the questions, a lot to do with diet, a lot to do with like the eating sort of window, whether you should change your diet based on your athletic endeavours. So if you're changing from just maintenance to a bit of a race, a bit about IBS and electrolyte intake, that sort of stuff. So that's going to be in part two. But part one is mainly to do with iron heading off your deficient, what are supplements infusions, all those sorts of questions. And Mikhail does a great job of providing the right information in a way that any runner can understand. And like I say, she does it with such passion. It was great. It's great to talk to. And there's a lot of questions. Like I said, we went a bit over time, but hence my decision to turn it into two parts, but um, If you haven't already, check out the YouTube channel, having a lot of fun with the YouTube channel. I have at the time of recording 350 run smarter scholars decided to start listening. I'm getting a lot of great feedback. And so it's just increasing my passion, enthusiasm for continuing with more episodes. So if you haven't already, I know it's on a lot of people's to-do lists and they haven't got to it yet, just search. run Smarter with Brodie Sharp onto YouTube, hit subscribe, and then you'll just be notified when new videos come out. Okay. Enough from me. Let's dive into my interview with Mikhail. Mikhail, welcome to the podcast. Thanks for joining me. Thanks for having me. I would love the audience to learn a bit more about you before we dive into these patron questions. So would you mind just kicking us off with, you know, your level of expertise and your passion, that sort of stuff? Sure. So, um. I'm a registered dietician by training, so clinically trained dietician, but I like to call myself a textbook dietician because instead of practicing clinically after I completed, got those credentials, I went straight to graduate school and got a master's and PhD in nutrition. And that's where my sort of... love for iron. So if you have a PhD in nutrition, you get to have a very favorite nutrient and my favorite nutrient is iron, which is what we'll be talking about today. I've been studying iron specifically since about 2007. And in that time, so while getting my degrees, I ran in college for TCU, Texas Christian University. I ran in grad school to pay back my student Um, kind of kept them both going at the same time. And so, um, since finishing my PhD, I, uh, kind of switched fields and did, uh, postdoc in cancer, uh, biology, and then take, took that into my own lab. I started my own lab where I study nutrient gene interactions and chronic disease development, but specifically in relations to alterations in iron metabolism with the tune within the tumor. But. I love to run and I still love to run and iron is just such an essential nutrient, not for everyone, but runners especially. And so I use that, you know, my understanding of iron to help fuel my own performances and I have been pretty successful since, been more successful since I started my own lab actually so I think it's working out well. Since starting my own lab in 2017, I qualified for the Olympic trials in the U.S. Um, I've lowered my marathon PR to a two 34 and I think I can go faster. So, uh, just, just trying to keep that good balance. I mean, wow. Nutrition will work and running. Very cool. Yeah. Very cool to have those two passions and that they compliment one another, you know, delivering that iron information to, to runners and then just putting into your own practice. That's very cool. Let's dive into the role of iron. If people aren't familiar. they've heard of it, but they don't know really what it is and what the function is. Why is it so important, particularly like you said, for runners? Well, lesser known things maybe that we don't even think about, but iron is essential for life. So it's an essential nutrient. You have to have to live. And one of the reasons you have to have it to live is because you need iron to actually make the DNA that makes you up. You use iron to repair that DNA. If it gets damaged, it's a plays a critical role in oxygen transport. Iron in the form of heme and hemoglobin in your red blood cells is what transports oxygen so you can breathe and move. It's essential for energy metabolism. So you eat your food, but to actually get energy from that food to move, you need iron. So it does all those life-sustaining functions. But for endurance, Or for with running for talking about running specifically, you know, really we're focused mostly on that oxygen transport because that's oxygen transport in the blood and it also plays a role in oxygen transport in tissues as well in a slightly different protein. So it's what keeps us moving. Yeah, very important. And I guess for runners, when you're talking about the importance, yes, we want to perform. Yes, we're, we're constantly moving and need that essential nutrients. But in regards to, I guess, energy levels or like iron levels, is it more threatening that a runner might, um, have decreased iron levels? Uh, generally just the runner's going to notice it more. So across the board, iron deficiency, whether you're a runner or not, um, reduces your aerobic capacity, right? So your capacity to transport oxygen. is limited whether you're a runner or not, but if you're trying to run you're gonna feel that those effects more. It also reduces your endurance capacity. So now not only are you breathing harder, you're working harder, you fatigue more quickly. So again you're gonna feel that especially if you're an endurance runner you're gonna fatigue more quickly than you normally would. Another thing that it's been shown to do for athletes is actually decrease your we call energetic efficiency, which means that a runner who is iron deficient would actually have to work harder to accomplish the same set a task as someone who is not. And so, you know, all these things are. Influential to anyone, but if you exacerbated by the fact that you're trying to do something that requires oxygen that requires endurance and requires energy. Hmm. And about the, I guess, taking in iron and losing iron, what do athletes need to be mindful of? Well, um, probably an important thing to be mindful of is, um, no matter how much iron rich foods you consume, say you do eat a lot of meat, you eat lots of spinach, you get in those high fiber or high iron, chia seeds and legumes, iron is not very efficiently absorbed. And so that's one of the major reasons that it's the most common nutrient deficiency worldwide. So not even talking about runners here in the world. billion people on the planet are iron deficient. One of the reasons for that is because it's just not what we call bioavailable, which means it's not absorbed particularly well by the gut. So it's important to eat those iron rich foods regularly. And because of that in certain individuals and runners too, sometimes even if you do have a sufficient diet, supplementation is still necessary, especially in those female runners. Um, that's an important thing to keep in mind. But the flip side to keep in mind is just like anything, even oxygen, more is not always better. So there's a toxic, you know, toxic, toxic level to iron. You can have too much and too much iron is way more serious than not enough iron. Too much iron. You. It's one thing to not be able to finish a workout to not be able to go as hard as you want to too much iron can lead to things like cardiovascular disease, diabetes, cancer, all sorts of other problems that are way worse. Okay. Is there a way that we can make the iron rich foods or eat different foods that can be absorbed more easily? Or is it just a fact that, you know, just all foods are just hard to absorb? So, um, heme? Iron, which comes from meats, is more efficiently absorbed than non-heme iron, which is the kind of iron that comes from plants. So if you are okay with eating meat, getting your iron from meat is the most efficient way to do so. If you stay away from meat or limit meat, you can help promote absorption. by including things like vitamin C with that. So like a vinaigrette on your spinach salad, some orange juice with your chia pudding, those sorts of things to help promote that absorption. And also staying away from things that interfere with iron absorption. Things like tannins, which are found in teas, and coffees can interfere with iron absorption. other types of, we don't think, don't think of it as metals necessarily, but things like calcium, magnesium, those can interfere with iron absorption as well. So it's kind of one of those things you like to say, oh, I buy this cereal and it says it has a hundred percent of my daily value of iron. And then you have that in milk, which has calcium that's going to compete for uptake in the gut. So, um, I mean, I'm for both, at least you get some, it doesn't take it all away, but you just have to keep those things in mind, try to balance that. Maximize. I remember from one of another interview that you did that I was listening to, you mentioned that iron once it's absorbed into the body, just really just stays there unless there's a means of like other like sweat menstrual cycle, that sort of stuff. Um, can you maybe explain that a little bit more? Cause I found that quite fascinating and, um, just, I guess, highlight it in a way that it might be useful for a runner. Yeah. Um, so. Yes, so we don't have any means of iron export from the body, that's correct. So once it's in, it is in, you can lose it through bleeding. So people who have like iron overload disorders, how they recommend major recommendation for treatment is to give blood. Not only does it provide nice iron rich blood for those who need it, but it helps you get rid of your iron. One of the only way, menstruation for females, like you said. we can lose a little bit as runners and as endurance runners, the more endurance you have, the more you get what's called foot strike hemolysis, which means literally the pressure of striking your foot to the ground ruptures your red blood cells. And then those get kind of reabsorbed, digested and can be urinated or defecated out a little bit, but no way to get it out. So Why that's important because again, in thinking about that toxic levels, we have this tendency to sometimes see, oh, I'm a little bit more tired than I used to be. I'm fatigued. And somebody says, oh, you're a runner, you're iron deficient. Go take a supplement. Okay, sure. That makes sense. And then you take that supplement. But maybe it was something else. Maybe you were sick. Maybe you really had plenty of iron and now you've taken that supplement and now you have it in you and it's in you. to stay until you get it out by some other means. So, um, I, you know, it's important to get it in, but it's important. You got to maintain that balance. Yeah. All right. I think that's, that's up really well to start answering some of these questions coming in from the patrons. The first one I have is from Jackie who says there's days when I feel fatigued around that time of the month and assume that it's because of low iron and energy. And she asks, do I train or consume more iron rich foods on those days when she has particular, I guess, feeling more fatigued. Mm hmm. Um, so with that, so in having to do with that whole, um, import export, right? We get iron in, but we don't get it out. So assuming Jackie is not anemic or iron deficient, even though you're going to lose some iron. through menstruation, unless you're an excessively heavy bleeder, that fatigue is probably not due to iron loss. It's probably just not fluxing enough. As you lose that little bit of iron that you will lose with menstruation, your body will actually compensate and absorb more to maintain that balance, which is really neat. So the more iron deficient you are, actually the more efficient you absorb it and vice versa, which is great. The body is efficient. So on those days, Jackie, your body's probably absorbing more to make up for it. So it's great that you're consuming those iron-rich foods during, but the fatigue, probably mostly hormonal. Thus is life of being a woman, and I sympathize. I think consuming higher energy foods, yes, because your body's doing things that's taking more energy too. You probably need a little more calories those days. Again. Iron rich foods are a great bonus. You're probably absorbing more, a little bit more about those times. It's most people that I know that are sort of heavy menstruators or have really significant problems with fatigue and pain, really just listen to their bodies and take that time off. If you need those one to two days a month, if anything, training through it to cause more fatigue is gonna do more harm than good. So mostly probably hormonal, lighten the load. Take a rest day, eat your good food, but you're not like cycling between deficiently iron, iron deficient and not just the hormonal flux. Unfortunately. I think that's a good takeaway of saying, you know, just keep to a nice healthy diet and it will have some iron in there and your body's just going to do the job of not absorbing it or absorbing it. Um, and fluctuate with those absorption rates based on what the body needs. That's a, it's a great tip. yeah it does a great what's fascinating is to me is so you have about you only absorb between two and four milligrams of iron two and four milligrams of iron a day average person that's what we absorb because that's about what we lose each day so we completely if you lose about three grams a day you absorb about three grams a day that's how the body works we so that's milligrams excuse me We have 25 grams of iron in our body. So that's a thousand plus more fold. So we're just efficient, efficient users of it. We recycle it exquisitely. The body makes a billion red blood cells a second. It just has to be good at using it. So, all right. Great. I had two questions come in talking about iron infusions. I had Olivia say. Does running create the need for a higher iron diet? I think we've kind of somewhat answered that already, but she continues to say, I get drops in iron post-infusion and wondering if running plays a role in that. And then we had Michael asking, I've had some iron infusions to keep my levels okay, and asked about supplements and told they might be dangerous. Let's start with Olivia. So asking about does running itself require or a need for a higher iron diet. What can we say for Olivia? Um, in short, Olivia, yes. Um, some of that is a little bit more overall. We consume more calories, higher energy demands. Um, your iron needs are going to go up somewhat with increased energy demands too, and to provide those energies. Um, sometimes we also need it because of that. Like I said, I said that foot strike, homolysis. non-runners aren't getting that constant pounding and breaking down those red blood cells and needing iron to replace those. So that can increase needs a little bit of runners. Another thing to think about, it just depends and we'll kind of get into this to a question later, but exercise induced inflammation, so if you're kind of training hard for something, can impair absorption. So one of the things that will, it's a body's natural stress response when you get sick from like a path of bacteria, you absorb less iron to keep it away from the bacteria. So if your body thinks it's sick, it won't absorb as much iron. So if you're like over training to the point where you have some inflammation, you'll absorb less iron. So you might need to consume more to counterbalance that. We lose a little bit of. little bit of iron and sweat, but if you're sweating a lot, right? You're gonna perhaps need a little bit more. Harder bouts of endurance exercise can result in what we call hematuria. That's the medical term for blood in your pee. You can lose a little bit that way. So all those are tiny, usually mostly negligible amounts, but with endurance and chronic training over time, that can add up. So yes. runners need a diet that is higher in iron than the average person. So yes, if you're running post infusions that could potentially change it. That's a little odd to see it drop and without more information and knowing what your measure of strange drops in iron, you know, is that Transference saturation. There's so many measures of iron indices. I don't really want to go there. I hope that your general practitioner and you continue to work together, um, to find that out, but yes, you do need more. Now you want to kind of recap Michael's question. Yeah, that'd be great. So Michael said, um, I've had iron infusions to keep levels. Okay. Like an okay level. I asked about supplements and told it might be dangerous and said, can I better manage maintaining iron levels without infusions. And he says he already tries iron rich foods in his diet. Okay, so great. So we talked about iron rich foods in the diet are great and should continue to be included, but for some runners, because of all the things that we've just been talking about, that still might not be enough. And so the thing to keep in mind is that oral supplementation is safe and it works well under two circumstances. it's safe if the person is iron deficient, right? It needs to increase their iron levels. And it actually works well when the person is iron deficient. So we can talk a little bit, I think, with a question later. If you are iron deficient and you start supplementing iron, you absolutely will likely notice an improvement in your overall wellbeing. The other thing though, and my God, I don't have your health history here. is that it's safe and it works well if there is not any sort of underlying condition that's going to interfere with absorption. I mentioned inflammation, I mentioned sickness, you know, those can interfere with absorption even if you're taking a supplement. If you have some bowel syndromes, irritable bowel syndrome, Crohn's disease, other types of You to have ulcers and you take medications to treat those ulcers any of those things can interfere with absorption and so that might prevent your supplement from working well I Can't think of a scenario when someone does have normally a normally functioning gut that infusions would be a better choice than a supplement So I feel like maybe there's something else going on there There are also genetic disorders, I study genetics, that people have that they're called iron refractory anemia, which means no matter how much iron you put into your mouth it is not going to be absorbed. And so if that, again, that's a fairly rare condition, but it's out there. So, infusion warranted. If you want to take your running wisdom to the next level, then I highly recommend signing up to receive regular Run Smarter emails. Once you sign up, you'll receive my weekly blogs, research paper summaries and podcast insights. You might be aware that I regularly post information across Facebook and Instagram, but I know not every blog will reach you. There are simply too many posts competing for your eyeballs and I'd rest a lot easier knowing that runners who want this content are receiving it safely into their inbox. the additional links and resources I include within my emails means you will get the upper hand than reading it on social media. So if this interests you, there'll be a sign up link in the show notes. I need more information. It's just, but you're doing a great job of answering and also advising that there might be other conditions out there or more information might be needed. Are there certain myths or misconceptions out there about supplements? Cause I haven't seen any, but I've also got questions from Rachel and Laina saying, Rachel says she doesn't eat a lot of meat. She does iron supplements every second day, but asks, is it a waste of time? And then Lena says she takes iron supplements, but here's that there's danger longterm. So with a couple of these questions coming in saying, I've told it might be dangerous. I told danger longterm. Is there anything that you can clear up or have you, do you know of any ways that it might be harmful? Well, so, so again, if you are not iron deficient supplementing iron could be harmful. You're not gonna get that iron back out of your body. And it just kind of sticks. It sticks in places that you need to work well. First place it'll still go is your liver. You're not gonna get it back out of your liver. And it goes to your pain. So yes, supplementing iron when it is not necessary could potentially be dangerous. Also, I think she mentioned something about wasteful. And again, so I'm trying to be soft here could potentially be dangerous I'd said this before if you don't need any iron your body will try really hard not to absorb it And so yes, if you don't need it your body will basically shut down as much as it can and you'll Poo out that supplement. Yes, potentially wasteful and that's the best That's the best case scenario if you don't need it and you're taking it. You hope you poo most of it out Cause you don't want to get stuck in your liver places that you need functioning. Yeah. It seems like a lot. Like if you're talking about the, I guess, outside of the menstrual cycle, day to day, you're not losing a lot of iron, but then if the iron supplements are like safer, Rachel every second day and that sort of stuff seems like a lot. It seems like they're, I don't know. Is that, um, if someone is deficient and Is there different strengths of supplements? Is there a recommended like frequency to take them? Well, this really, um, you know, unfortunately is a little bit of trial and error. I mean, we give blanket recommendations to pregnant women. Yes. Supplement, you know, as long as there aren't any other conditions because, because iron's so critical for the development of that newborn. So I'm blanket gonna say supplement. you know a low dose but make sure you're getting it in. It's hard to blanket say something like that. As a general rule in a healthy woman menstruating woman who runs I'd like to blanket say it's safe to take an iron supplement and by and large it probably is. So personally I can go to I have been taking an iron supplement Pretty much daily since I was a teenager, 37. Just had my iron levels checked, they're fine. Part of that is because through trial and error, I've learned that I cannot maintain iron levels without a supplement. I've tried not taking a supplement, everything drops. So I, but again, nothing long-term, still healthy, iron levels are normal. So, you know, again, in a... Menstruating female probably you're okay men There are reasons they might need to supplement certainly that happens not as common But my warning statement is probably comes just from a close friend of mine. We were training for a marathon together in college Both getting our PhDs in nutrition. She also had a master's in ex-phys and other you know So we all had all this information and I'd known I'd struggled. I've been struggling with iron deficiency since high school. I'd Poor grad student, money was tight, stopped buying supplements, started feeling like crap, running started to go downhill. I said, you know what, my iron's low, we've got a checkup, sure enough it was. So my friends, same thing, feeling bad, haven't been eating good, don't have money, I'm tired, maybe I should take an iron supplement too. But she also went to the doctor, same time. Turns out she actually does. carry the genetic variant for iron overload disorder. It's very common. One in 200 people, the iron overload is much more common, one in 200 people carry the variant to have that. So you don't just want to supplement if you don't need it. I mean, it would have been very dangerous for her to have done so. And it would potentially be dangerous for one in 200 people. So yeah, there's some good and some bad. So, you know. Danger is a strong word, but there are these instances out there where I, I'm glad that people aren't just like, well, I'm a runner, I take iron. Certainly question it. For those, like a lot of the recommendations that you have is like, okay, it's tailored to the individual and tailored to their own iron levels. I guess it's just probably, I probably should ask this beforehand, but is it just a blood test is, um, First of all, to find out your iron levels, but also to find out if you have some sort of genetic alteration to fail that fails to absorb iron. How do you go about those procedures? Uh, so really good questions. The whole, let's start with the, do I need to take an iron supplement? Right. Let's start with that. The easy one. We can easily detect how much blood you have in your, or how much iron you have in your blood. However, if you go to the doctor and you say, I think I might be iron deficient, he's gonna check your hemoglobin and hematocrit levels. Hemoglobin is the protein that transports oxygen and it's the major iron-containing protein in the body, has most urine, and hematocrit is a similar iron-containing protein. And that's great. But he might say it's normal. my hemoglobin and hematocrit have always been normal. Those don't drop until you are anemic, which means not all your iron stores are gone, your tissue irons are gone, and now your iron levels are so low, it's actually functionally impacting you. So that's probably what they'll test, because that's cheap, insurance is a gun cover and it's cheaper, but they don't. So if you're really, as a runner, and you're concerned, you might, you specifically say, I want you to measure my serum iron, the absolute, the total amount of iron in my blood. They might also do that by doing something called iron binding capacity, so sometimes called transfer and saturation. Those are three really similar measures. But for a runner, I recommend one or two of those measures because those will get lower first. And then the much more sensitive one that we have a question about later is ferritin. Ferritin is the protein that stores iron. So you use it for red blood cells and to make DNA and do energy. That's your functional iron. And then you store it because if you run out and you can't make red blood cells and you're in trouble. So ferritin is the first thing to drop. So the... Earliest indicator that you're not getting enough iron is your ferritin will drop Then your iron then your hemoglobin and your hematocrit So you can kind of take that tier ferritin is an expensive test Not all insurance will cover it just because you want to just throw that out there So the genetic test how do I know if I potentially have this disorder thing is if you are a runner and They test your ferritin. Ferritin, again, is that really good indicator. They can test your ferritin, and if you're a runner and if it's above normal, which it will be if you have that iron overload disorder, they pretty much know. They'll send you to a specialist to follow up, but you pretty much know based on high ferritin, high serum iron. You can go confirm which variants you have and how likely you already give it to your kids and that sort of thing, but that's... Okay. like 23andMe, whatever, they'll all they test for those things too. The iron refractory anemia is so rare, you'd have to have other things going on and then probably go to a specialist who would then potentially recommend it. Okay, yeah, I think we might cover that ferritin question now just to make sure that Reanswer because Lana asked what is the optimal ferritin levels for recreational runners and I heard that a normal range is too low for runners. I guess the normal range of the general population might be too low. So do recreational runners need to have a higher level than, than the general population? Um, there's no definitive. Yes. No, it needs to be this, but I can give you a ballpark, Lena. So the normal for a general population is a pretty big range. It's 15 to, around 15 to 150 micrograms per liter. That's considered normal. For example, so my friend went in, how she knew she had it, her ferritin was like 300. So they were pretty sure. First time I had mine measured, it was three. I felt garbagey. The... But what I did find, Lena, was that in athletes, if their ferritin is less than 20, so, right, we said low for the general, so you won't get flagged by the doctor if it's 16, 17, 18, 19. That would be considered normal. But studies in endurance athletes show that less than 20 seems to have a functional consequence. And that's evidenced by the fact that when they supplement runners whose ferritin is less than 20, their work capacity increases. And I'll say this again, more is not better. So for runners whose ferritin was 50, if they gave them an iron supplement, they didn't improve. They didn't need it, right? They were fine. So yeah, a smidge higher than the general population. Not a ton. And getting it, bumping it to the upper level is not gonna help you run better. And that concludes another Run Smarter lesson. I hope you walk away from this episode feeling empowered and proud to be a Run Smarter scholar. Because when I think of runners like you who are listening, I think of runners who recognize the power of knowledge, who don't just learn but implement these lessons, who are done with repeating the same injury cycle over and over again. who want to take an educated, active role in their rehab, who are looking for evidence-based, long-term solutions, and will not accept problematic quick fixes. And last but not least, who serve a cause bigger than themselves and pass on the right information to other runners who need it. I look forward to bringing you another episode and helping you on your Run Smarter path.