# Is my hematocrit low?



## mpetersen16 (Apr 26, 2006)

Went to the doctor's office today, got my blood tested for mono because my neighbor has it, and I have been feeling under the weather lately (guess it's overtraining), the test came back negative for mono, but the doctor told me my hematocrit level of 39%, and that my hemaglobin is 12.4. These levels seemed low to me, so I asked the doctor who just kinda shrugged and said no that's fine. Then I looked at the chart later, and it shows the male range as being from 42-48, and the female range as being from 39-46 (that's for hematocrit). I was also low on the female scale for hemaglobin and off the men's range also. I have been cycling for about 3 months, before which I played badminton and ran cross country. I am slow in nothing I do, is it possible that my body is more efficient at replenishing my muscles in the same way that L.A.'s body is more efficient at using lactic acid, therefore producing and needing lower levels? Other thoughts might be that because I am growing still (I am 17 years old, though I dont think I will grow much taller) that my hematocrit might increase? I asked the doctor that, but he kinda shrugged it off also, saying that in march this year my hematocrit was 38.9, so it really hasn't increased. Can hematocrit increase through exercise much? Also is there anything I can do (food to eat) to increase hematocrit (besides doping, even epo-no has been suggested but I won't try that, preferring something more natural)? Perhaps sleeping at altitude, although I have no way of getting an altitude tent, and I live in Florida, so I doubt it will happen lol.
Thanks for any advice/opinions,
Matt


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## quattrotom (Jul 15, 2006)

Don't worry about your hematocrit. The test performed in the doctor's office is typically far from accurate and the the ranges you cite are for the middle of the population (probably +/- 1 or 2 standard deviations). Your value is not necessarily abnormal (but I'm not an MD).

I'm a PhD student in a lab that used to do a lot of red blood cell research. I am fortunate to have access to a large supply of capillary tubes and an old centrifuge used for making the measurements.

As young scientist with an engineering and statistics background - I love numbers and patterns. For a while I was measuring my hematocrit almost daily and sometimes 2-3x a day. 

Here was my simple take home analysis:
- The measurements were quite reproducible - but it's easy to see how one technician could record a different value from another technician. It's similar to reading a thermometer, but more difficult. This is where I think there could be significant error (+/- 2% would be a simple estimate of the error from one "reader" to another)
- My values varied significantly from day to day. I believe my typical range was from 39-45 within the same week (different times of day, different levels of hydration, training, etc.)
- My all time highest reading was 46, lowest was 39, with a mean and mode of 42 or 43.

There are a lot of other things going on in your body. The volume of your red cells is only one factor in your athletic performance - like you suggested, there are the issues of oxygen and nutrient transport to your muscles, function of your lungs, lung volume, etc.

I think of hematocrit like the displacement of a car's engine. Just because your friend has a 5.0L V8 in his 10 year old mustang, doesn't mean his car is faster than a Porsche 911 turbo with a 3.6L engine. How a human body uses that red cell volume is probably more important and more variable from individual to individual, just like engine and transmission efficiency.

Hope that helps. Go out, ride your bike and enjoy it. 

Tom

Disclaimer - I have no idea how one would measure hematocrit down to 0.1% with a standard hematology centrifuge and capillary tube. Maybe there is a new device in use and in that case your number is more accurate than my guess of +/- 2%. In any case, the variability between measurements is real as I found my own measurements were quite reproducible with the equipment available to me. If you have any other questions feel free to ask.


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## mpetersen16 (Apr 26, 2006)

*is Anemia possible?*

I ask, because my value was basically the same when it was measured back in march, I have been feeling under the weather lately, is it possible that I have dilutional anemia, or even an iron deficiency (I usually eat plenty of meat, and take a one a day centrum). http://www.cptips.com/blood.htm is a link that discusses some of the possible reasons for low hematocrit in athletes
Thanks for the help
Matt


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## quattrotom (Jul 15, 2006)

*overanalysis*

Like I mentioned before - you are probably worrying over something that's fine and can't easily and safely be changed. 

Why did you have your hematocrit tested in March? Did your doctor have concerns over your blood?

Your doctor probably performed an iron test, so I doubt that's the problem. If you don't think he did and don't want to waste time on another doctor's visit, help out your fellow man and donate your blood. Each time you donate blood they check to see if your iron is too low - you can see them test it right in front of you. 

For a disturbing aside -
In my work, I study a type of white blood cell which can be isolated from your whole blood using a centrifuge and appropriate buffers, etc. One morning following a very late night of drinking and eating fatty foods (wings and cheesesteaks), I was separating my white cells from red cells. After performing the separation procedures - I found I had more fatty material in my blood than white cells - in fact it was so disgusting that I could barely separate the cells in the usual manner. I lost many of the white cells in the prep due to this thick fatty layer. I couldn't believe that eating 7 hours earlier had caused such havoc on my blood. And I couldn't believe this filth was still in my blood 7 hours later !

So my lesson to you - eat well and don't worry if you're short a few red cells.


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## moab63 (Aug 7, 2006)

*As a very interesting note about this*



mpetersen16 said:


> Went to the doctor's office today, got my blood tested for mono because my neighbor has it, and I have been feeling under the weather lately (guess it's overtraining), the test came back negative for mono, but the doctor told me my hematocrit level of 39%, and that my hemaglobin is 12.4. These levels seemed low to me, so I asked the doctor who just kinda shrugged and said no that's fine. Then I looked at the chart later, and it shows the male range as being from 42-48, and the female range as being from 39-46 (that's for hematocrit). I was also low on the female scale for hemaglobin and off the men's range also. I have been cycling for about 3 months, before which I played badminton and ran cross country. I am slow in nothing I do, is it possible that my body is more efficient at replenishing my muscles in the same way that L.A.'s body is more efficient at using lactic acid, therefore producing and needing lower levels? Other thoughts might be that because I am growing still (I am 17 years old, though I dont think I will grow much taller) that my hematocrit might increase? I asked the doctor that, but he kinda shrugged it off also, saying that in march this year my hematocrit was 38.9, so it really hasn't increased. Can hematocrit increase through exercise much? Also is there anything I can do (food to eat) to increase hematocrit (besides doping, even epo-no has been suggested but I won't try that, preferring something more natural)? Perhaps sleeping at altitude, although I have no way of getting an altitude tent, and I live in Florida, so I doubt it will happen lol.
> Thanks for any advice/opinions,
> Matt


Last year a racer(road) had an accident down in baja, some of us new the guy, we went to the donate blood for him. Everyone of us racers were told that we had border line Anemia. I had read about sport anemia, common on endurance athletes I tried to explain this to the person at the blood bank but they wouldn`t have it-

Dave Morris on his book talks about all of this in great detail. So exercise will lower iron, and some food inhibit the rate of absorption. Meat will red or dark chicken meat, also cooking with a iron skillet mineral supplemnets.


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## dm69 (Jun 16, 2006)

Dont worry about your hematocrit...sounds like you just want an excuse to dope? To me 39 seems normal. Ride your bike.

If your a pro racer buy yourself an altitude tent to get it up to 49.99999%


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## bas (Jul 30, 2004)

moab63 said:


> Last year a racer(road) had an accident down in baja, some of us new the guy, we went to the donate blood for him. Everyone of us racers were told that we had border line Anemia. I had read about sport anemia, common on endurance athletes I tried to explain this to the person at the blood bank but they wouldn`t have it-
> 
> Dave Morris on his book talks about all of this in great detail. So exercise will lower iron, and some food inhibit the rate of absorption. Meat will red or dark chicken meat, also cooking with a iron skillet mineral supplemnets.



There were new "slow" absortion Iron supplements in the grocery the other day. They appeared to be for people with doctors orders to get more iron supplement. 

http://www.naturemade.com/ProductDatabase/prd_prod.asp?productid=55

I don't know if I should start taking 1 every other day or something if it would help any.. I don't think I eat much red meat.


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## Kerry Irons (Feb 25, 2002)

*Some insights*

First, you are borderline anemic, though that may be your normal state. Also, in the summer time when you are exercising a lot, you tend to be a little more hydrated, and this dilutes your plasma volume, often resulting in a lower Hct. The fact that it was the same in March suggests that maybe this is "normal" for you. Your doctor, however, is likely NOT clued in to performance issues related to Hct, and so will always tell you that you are OK as long as you are in the normal range, even if you're right at the bottom of it.

quattrotom has some reasonable insights on testing variability and on the fact that you can't really compare your Hct with another's and draw meaningful conclusions. The fact that you are only 16 may have an impact on all of this, though I don't know what it might be.

Here's my story - I have been riding a weekly 10 mile time trial for 20 years, and my times were very consistent from 1986 through 2001. Starting in 2002, my times dropped by 1 minute or more, like a switch had been flipped. I have also regularly donated blood since 1984, and starting in 2002, my Hct dropped from the low-mid 40s to the upper 30s (38 minimum to donate blood), occasionally being too low to donate. I talked to a number of people about this "problem" and the medical folks were all the same - you're in the normal range so don't worry about it. Finally, in January of this year, I started slow-release iron supplements, even though my diet was already well over 100% of the RDA for iron. By May, my Hct was up to 45 and my time trial times have returned to their historical norms. While I was "normal" by medical standards, my iron reserves had dropped so low as to affect my performance.

You might want to look at your diet, and even try slow release iron for 6 months to see if it has any effect. The fact that I have 20 years of time trial data gives me great confidence in my conclusions.


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## llvllatt (Jul 23, 2005)

Back in late May/early June, a few weeks after increasing my training load, I was starting to feel slightly drained, not putting out great performances and started being afraid I had overtrained after 5mo of training less than 10hours/week, and I had to leave for Nationals later in June.
Someone offered to give me free blood testing, so I jumped on it right away. My Hct came back at 36%. I was fortunate enough to be tested by someone with a sports medicine background, and spent a while talking about my diet, training schedule, performances etc.
While red meat isn't a staple for me, I eat enough of it that for most people it shouldn't be a problem. The doctor told me to start taking iron suppliments, he said that should bring my Hct up and get rid of the overtrained feeling pretty quickly.
Over the next 2 1/2 weeks taking iron suppliments every day, I felt a lot better, dropped about 45seconds off of a 14.8km TT course, breaking 20min for the first time. I wasn't feeling 100% through Road & Track Nationals, and another UCI race I went to, but since I got home, I've been feeling great, rode 18:56 on that TT course a few days ago.

Try taking some iron, but it can be very genetic, and you may just naturally have a low Hct, in which case, you shouldn't worry about it too much.


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## vonteity (Feb 13, 2005)

quattrotom said:


> For a disturbing aside -
> In my work, I study a type of white blood cell which can be isolated from your whole blood using a centrifuge and appropriate buffers, etc. One morning following a very late night of drinking and eating fatty foods (wings and cheesesteaks), I was separating my white cells from red cells. After performing the separation procedures - I found I had more fatty material in my blood than white cells - in fact it was so disgusting that I could barely separate the cells in the usual manner. I lost many of the white cells in the prep due to this thick fatty layer. I couldn't believe that eating 7 hours earlier had caused such havoc on my blood. And I couldn't believe this filth was still in my blood 7 hours later !
> 
> So my lesson to you - eat well and don't worry if you're short a few red cells.


This is very common. I used to give platelets regularly, about once every three weeks before my veins got turned to swiss cheese from all the poking. Since I ate very healthy and mostly low-fat foods, they never had a problem with my platelets. The bag of plasma they get from you should look like pee or movie theater butter oil. In other words, clear and yellowy. Quite often you'd see someone giving platelets, and their bag would look like cottage cheese mixed with melted butter. More often than not, these people were morbidly obese. They must have lived on a high fat diet. The technicians used to tell me that they wouldn't be able to give their donations away, no less sell them. They politely took the donation, reminded them to avoid fat next time, and threw the donation away.


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## vanjr (Sep 15, 2005)

From a medical viewpoint your hematocrit and hemoglobin values are fine.


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## ChilliConCarnage (Jun 1, 2006)

Not to derail from the OP's thread, but I have a related question...

My hematocrit was last tested in March and came in at 50% (with a high RBC of 5.75). While I don't have access to any of my previous medical records, I seem to remember that my crit is usually on the high side (49-50). Is there any danger of you crit being too high? Isn't the purported reason that the UCI restricts crit levels to under 50 because it is unhealthy?

I should mention that I am cycling a lot to try and recover from a car accident (and resulting 2nd ruptured disc) so I am not exactly in shape yet, but I'm not taking any kind of drugs or supplements, and I'm a regular fast food eater. I know that from a performance standpoint having a high RBC/Crit is supposed to be a good thing, but I sure haven't noticed that it gives me any kind of advantage.


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## Doggity (Mar 10, 2006)

*Too high a crit isn't a good thing either.....*



ChilliConCarnage said:


> Not to derail from the OP's thread, but I have a related question...
> 
> My hematocrit was last tested in March and came in at 50% (with a high RBC of 5.75). While I don't have access to any of my previous medical records, I seem to remember that my crit is usually on the high side (49-50). Is there any danger of you crit being too high? Isn't the purported reason that the UCI restricts crit levels to under 50 because it is unhealthy?
> 
> I should mention that I am cycling a lot to try and recover from a car accident (and resulting 2nd ruptured disc) so I am not exactly in shape yet, but I'm not taking any kind of drugs or supplements, and I'm a regular fast food eater. I know that from a performance standpoint having a high RBC/Crit is supposed to be a good thing, but I sure haven't noticed that it gives me any kind of advantage.


 If you've got too high a crit and Hgb consistently, you've got a condition called polycythemia.While it can be genetic, it can also be the body's response to chronic nocturnal hypoxemia, (low blood oxygen) while you sleep....usually from severe, untreated obstructive sleep apnea. So...if you are overweight, your bed partner tells you that you snore/and or stop breathing at night, and especially if you have high blood pressure that's resistant to medication, GET A SLEEP STUDY! The life you save may be your own. This condition unfortunately is common, and WAY under diagnosed and treated.


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## ChilliConCarnage (Jun 1, 2006)

Very interesting. My father has severe sleep apnea, but I don't appear to have any such symptoms. But, I am a little overweight, and do have very high blood pressure. Perhaps I should have this checked out........


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## BendBiker (Jul 22, 2006)

*Orange Juice!*

It sounds to me that maybe you are overanalyzing your result, but If you want to make sure you're getting enough Iron that may not be a bad idea as others have suggested. If you are unsure about supplements and want to keep it simple, then just having a glass of orange juice before your meatier meals during the week may help. The Vitamin C in orange juice actually helps your body absorb Iron. The problem with Iron is that the body has problems absorbing it, even when it's in "heme bound form" (ie from meat), so a bit of OJ certainly can't hurt. Drinking a lot of coffee and teas can actually negatively affect iron absorption so you might wanna avoid such beverages around mealtime if you're really worried.

I too am a graduate student, and I have to sit through a lot of boring lectures on Iron processing, from a nearby lab. I also just helped my vegetarian friend research a low blood iron content and what to eat to increase her intake effectively. Hope this helps.


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## terzo rene (Mar 23, 2002)

ChilliConCarnage said:


> Not to derail from the OP's thread, but I have a related question...
> 
> My hematocrit was last tested in March and came in at 50% (with a high RBC of 5.75). While I don't have access to any of my previous medical records, I seem to remember that my crit is usually on the high side (49-50). Is there any danger of you crit being too high? Isn't the purported reason that the UCI restricts crit levels to under 50 because it is unhealthy?
> 
> I should mention that I am cycling a lot to try and recover from a car accident (and resulting 2nd ruptured disc) so I am not exactly in shape yet, but I'm not taking any kind of drugs or supplements, and I'm a regular fast food eater. I know that from a performance standpoint having a high RBC/Crit is supposed to be a good thing, but I sure haven't noticed that it gives me any kind of advantage.


 if you have always been in that range it's nothing to worry about. If it has changed significantly over time then something is likely amiss. 

But if you turn pro you will need to get an exemption from the UCI to allow you to exceed the limits. ;-)


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## mpetersen16 (Apr 26, 2006)

Just to reply to all of you guys, I certainly have been feeling drained, although after taking iron for the last week, I am feeling better. I am quite certain it isn't sleep that gives me a tired feeling, because over the weekend I slept 9-10 hours nightly, which was hard to do, being that I am not accustomed to sleeping too much. So I am going to take 50mg iron daily, and take it with orange juice. I'll update this forum at the end of the week on how I am feeling. Thanks for everyone's advice.
Matt


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## Kerry Irons (Feb 25, 2002)

*Months, not weeks*



mpetersen16 said:


> after taking iron for the last week, I am feeling better. So I am going to take 50mg iron daily, and take it with orange juice. I'll update this forum at the end of the week on how I am feeling.


Replenishing your iron stores takes months, not weeks. If you felt better after one week, it was not likely an iron problem.


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## mpetersen16 (Apr 26, 2006)

Wouldn't it be wise for me to continue taking iron, on the chance that it helps increase my hematocrit? Are there any large hazards to taking 50mg daily?
Matt


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## magnolialover (Jun 2, 2004)

*Oh my Gosh!!*

Yes, your crit level is super low. You had better start taking EPO STAT!

OK, not really, just kidding.

Hope you feel better soon. Seriously.


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## FTF (Aug 5, 2003)

mpetersen16 said:


> Wouldn't it be wise for me to continue taking iron, on the chance that it helps increase my hematocrit? Are there any large hazards to taking 50mg daily?
> Matt


Just stop riding, you won't beable to turn a pedal with your current hemocrit level.


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## Kerry Irons (Feb 25, 2002)

*Wisdom*



mpetersen16 said:


> Wouldn't it be wise for me to continue taking iron, on the chance that it helps increase my hematocrit? Are there any large hazards to taking 50mg daily?


Assuming the doctor saw nothing "causing" the low Hct (some disease) then yes, I would keep taking the iron. Risk of iron supplementation is not large. You can Google and gets lots of info. After a couple of months, get your Hct checked again, and if it's up noticeably, then iron deficiency was likely your problem.


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## vanjr (Sep 15, 2005)

Cautions: hemochromatosis (excessive iron storage) is one of the more common genetic diseases in caucasian populations and can be serious. Males have it worse. Although low dose iron supplementation is ok, realize a large dose of iron (even one) can be fatal-particularly in children. Taking a 1 a day vitamin with iron is fine, but micromanaging your health based on one relatively normal CBC results is not a good idea. According to the OP values for a CBC, there is absolutely nothing to worry about.


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## hrv (Dec 9, 2001)

I have a pretty low HCT also and did some research awhile back that referenced the avoidance of caffeine containing products, at least within a few hours of taking iron supplements. Supposedly caffeine inhibits iron absorption.Google 'iron caffeine' to see if you should skip your Starbucks stops.

mc in hood river


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## mpetersen16 (Apr 26, 2006)

I have stopped drinking anything with caffeine in it, since I started racing. The only time is the after race meal, where occasionally I will have a coke.
Matt


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