Extreme Training Fatigue: The Diagnosis Your Doctor Might Miss

Training and race season can wear your body down. And while tiredness is expected, extreme fatigue and joint pain shouldn't be part of that equation.

Take Robbie*, a 30-something, Category 3 Cyclo Cross racer, and a Masters level Nordic ski racer. He's a natural athlete and extremely fit.  But something was wrong.

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"After a Cyclo Cross season, followed by a Nordic ski race season (ending in a 90K event), I stopped training, because I felt like I could never recover," Robbie said.

"I'd noticed the same thing the previous year, but had finally recovered after 10 days of no training. This time was different," Robbie said. "The fatigue remained after weeks of low to no activity. I got frustrated and started training again, because exercise would make me feel better for a short period. But if I took a day off I felt worse."

The more time he took off, the more fatigue he felt. The symptoms eventually prompted him to visit a doctor who works closely with athletes.

The culprit? Hereditary Hemochromatosis, an often misdiagnosed cause for extreme fatigue.

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The Results

After a complete blood workup, the results came back good, except for ferritin, which was 550.

"That's a bit high and the iron saturation test came back at 100 percent," Robert said.

Ferritin is the storage form of iron. The normal range for men is 12 to 300 nanograms per milliliter. The normal range for transferrin (iron transport) saturation is 20 to 50 percent. All of this spells excess iron content within the body. 

One more step was necessary to confirm his diagnosis: a genetic test for Hereditary Hemochromatosis (HH). Robbie's results were positive.

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