Advice on Training Through/Post Major Illness

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  • #5940

    Thanks in advance for any advice regarding this matter. I am greatly in debt to y’all and your great work in the training and outdoor athletic communities. I am writing to humbly request your advice and recommendation regarding how to train and recover from a recent diagnosis.

    In late September of 2016, I began to experience symptoms of chronic tiredness and blood loss during bowel movements that was far different than the heavy lifting induced hemorrhoids I had experienced occasionally in years past. These symptoms persisted with increasing severity over time. My “hard-headed” attitude assumed I could just power through it and that the symptoms would solve themselves over time. By May of 2017, I determined I had to have the problem assessed, due to how drastically my performance had dropped in all categories. I went from a 2 mile in 12:45 in SEP16 (which is poor for me historically) to a 14:49 in MAY17, lifting heavy sets of deadlift at 395 to 245, and dropping from a lean 172# to 158#. I was grasping at my fitness performance with no success and finally “dropped off the deep end” in June, when I was seen by the doctor and diagnosed with ulcerative pan-colitis, anemia, and iron and vitamin D chronic deficiency. My hemoglobin and hematocrit levels are both below healthy levels. In summary, the doctor said that due to my body’s inability to absorb nutrients (as a result of the immune system-related disease), my body was constantly in a malnourished state (burning muscle due to malnutrition in Army Ranger School was his example).

    I was given medication that has been very successful in suppressing the symptoms of the disease, and am taking every supplement under the sun (Multivitamin, Omega 3s, whey protein, beta alanine, creatine, Sportlegs, iron) in an attempt to recover my weight/muscle mass and aerobic endurance. Also on week 4 of the Whole 30, trying to self-diagnose any triggers for the symptoms of the colitis.

    Thankfully, even though I serve as a leader in the military, I’ve been blessed with a supervisor who has personal experience with a similar disease in a family member, who is happy to protect me to rest and to train as necessary to return to full health. Based on the recommendation of others with this condition, I’ve mixed hypertrophy training (~3x/week) with interval based aerobic efforts (2x/week) and a few long Z1 endurance efforts (1-2/week) in my personal plan in an effort to fight what this disease has stripped from me, for lack of a better term. I am using hypertrophy programming from MTN Tactical/Military Athlete combined with endurance methodology from Jack Daniels and TftNA. I’m seeing some return in muscle definition, but minimal weight gain (now ~161#). My most recent blood tests show another drop in hemoglobin/hematocrit again after an initial rise, even after 2 months of supplementation and a full month of rest before easing back into training at a reduced load and intensity. My body is rapidly recovering its anaerobic endurance (previously the best of my personal fitness attributes), but my strength is still pathetic and my aerobic system is entirely out of whack. A 4-mile run last week that felt pretty easy at an average pace of 8:50 had me in Z3 almost the entire time. It seems like my Lactate Threshold is as low as it could be.

    Any advice that you might have would be immensely appreciated.

    Thanks for all you’ve done and continue to do.

  • Inactive
    Anonymous on #5943

    Well this is a tough one for sure. I’ll start by saying that we are not qualified nor prepared to offer medical advice and what you need is medical in nature not fitness related. Here’s why:
    Training and fitness MUST stand on a solid healthy base and from the sounds of it you are not healthy at this time. I say this because; if your hemoglobin and hematocrit are falling again now that you have begun training again, you have a medical problem that is causing this anemia.

    I doubt if nutrition supplements or changing your training regimen is going to cure what is going on. I have had quite a bit of experience dealing with anemia in athletes and if you have not had your Ferritin levels checked you should. Ferritin if the crucial protein that binds to the iron molecules and transports it into the red blood cells. When ferritin is low, no matter how high your iron levels are you will be anemic. Low ferritin presents like chronic fatigue. Most docs are unfamiliar with this especially in training athletes. The lab will list normal range from about 15-200. I and many other coaches can tell you that anything below 50 and your performance will be impacted. Below 30 and you’re toast. I have worked with several athletes with ferritin levels below 10.

    Besides this recommendation (which is a shot in the dark, I admit) I am afraid that I can’t make any concrete recommendations other than to back way off training till you get well. You can train your way through illness, as you are probably been finding out.


    QuickSteady on #5944


    Your advice definitely rings true, and helps to hear from your perspective. I’ll see if I can get my doctor to run with the ferritin check and see if that gives any more indicators off of which to work. Whenever I do climb out of this rut, I am beginning to believe a long aerobic base cycle will be the right route to take. For the sake of planning and self-education, do you have any recommendation for a training plan that would build aerobic endurance over the long haul?

    Anonymous on #6091

    Depending on your goals, any of the plans we sell or that you can develop for yourself using out book; Training for the New Alpinism. All are based on improving the basic aerobic capacity.


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