T Nation

Chronic Health Condition?

Hi there!

I’m new to T-Nation and I found my way here via reading up on John Berardi and his ideas on nutrition and fitness.

Why I’m here is because I am very interested and serious about whipping myself into the best shape I can be.

Or rather, into the best shape a certain chronic health condition will let me be.

I’ll say up front that I’m not looking to use my medical issues to excuse myself into being a pansy. Rather, I am looking for solid advice on working WITH what I have to be the healthiest I can be without overdoing it.

So without further ado, here’s what’s going on:

The short story is that I have chronic anemia that is NOT caused by iron deficiency which puts my hemoglobin count at 7-8 vs the normal person’s 14ish.

The longer story is that I have a genetic blood disorder called Hemoglobin H Disease, which is a chronic and intermediate form of a type of anemia called thalassemia of the ‘alpha’ sort.

Instead of a regular person’s 14ish hemoglobin count, mine is at a constant 7 to 8.

How this affects exercise and physical fitness is that I have a much harder time getting enough oxygen because of this and for this reason, I fatigue more easily than other people do.

My body has to work at least twice as hard to get the same amount of work done even if I myself don’t feel it as such. As a result, I have a tendency to overdo things without me even realizing it until it’s too late.

This also affects my metabolism in that I have an increased metabolism to keep up with the energy levels that my body needs to function.

I know that of course, there are basic guidelines for nutrition and workout that everyone can follow, but I know that with this condition, there are probably a few more specifics I should/could follow.

The problem is in defining these specifics; I personally have no idea what they might be and quite frankly, the nutrition specialist and doctors I have seen have been little help aside from telling me to “not overdo it” and “watch the iron intake”.

Hell, I even got one doctor who told me to stop taking Taekwondo because I was “overdoing” it and could overtire myself.

But surely, there’s a way to work with this?

I can still do workouts while not overdoing it, right?

When I was in university, I loved hitting the gym and while I DID overtire myself a few times, I loved the feeling I got from each workout and I was probably in my best shape.

It’s been a few years and I miss that feeling and miss that body I had and this time, I really am serious about getting back into shape and staying there.

But I want to do it right this time.

I’d love to be able to have a more tailored nutrition and exercise regime that takes into account my health issue, but I don’t know where to begin since my own doctors can’t give any particular specifics.

Maybe experienced people out here might have more ideas?

Thanks for reading and I thank everyone in advance for any and all advice that might be given!

I don’t want to be negative, but the first step seems to be get another doctor that will work with you and help figure things out.

^ I definitely agree that getting a doctor who could help me figure things out would be a great idea, but…

Hematologists who know about thalassemia AND are nutritionists AND who work with bodybuilders and the like are… well… exccedingly hard to find.

First, I’d like to hide behind the statement that whatever you do should be checked out with some type of competent medical advice.

With that said, I’d think that perhaps you’d want to pace yourself. If the issue is doing too much at once, then do a bit at a time.

You could put in longer recovery periods, you could put a break in the middle of your workout, or maybe you could simply split your workout into multiple sessions over the course of a day.

The last one could be inconvenient unless you could get some dumbells and do lighter work and cardio on your own and hit the gym only for equipment and weight intensive things.

Another strategy could be to hit the gym five days a week, but only do three workouts worth of total volume. In short, find a way to do what you can, safely, within whatever limits you have to impose.

Hmm, it might also be possible to take supplements that aid mitochondrial function and energy metabolism. Perhaps things like CoQ10, various types of acetyl-l-carnitine, resveratrol and fish oil. You might want to check into those to make sure I’m not misremembering what’s what.

[quote]vroom wrote:
First, I’d like to hide behind the statement that whatever you do should be checked out with some type of competent medical advice.

With that said, I’d think that perhaps you’d want to pace yourself. If the issue is doing too much at once, then do a bit at a time.

You could put in longer recovery periods, you could put a break in the middle of your workout, or maybe you could simply split your workout into multiple sessions over the course of a day.

The last one could be inconvenient unless you could get some dumbells and do lighter work and cardio on your own and hit the gym only for equipment and weight intensive things.

Another strategy could be to hit the gym five days a week, but only do three workouts worth of total volume. In short, find a way to do what you can, safely, within whatever limits you have to impose.

Hmm, it might also be possible to take supplements that aid mitochondrial function and energy metabolism. Perhaps things like CoQ10, various types of acetyl-l-carnitine, resveratrol and fish oil. You might want to check into those to make sure I’m not misremembering what’s what.[/quote]

grins

It’s not hiding if it’s honesty.

And yes, I will definitely have my health condition monitored throughout everything.

Thank you for your thoughts on possible supplements; I actually already take CoQ-10 and have been looking for a good fish oil to supplement.

As for the altered/modified training regime; that sounds like an excellent idea. I copied and pasted your advice and saved it for future reference.

Definitely though, I believe I should check in with a qualified health specialist with a preliminary schedule to see if the workout I want to do will be okay.

Also, I got a PM from a member here linking me to an article about a bodybuilder with thalassemia and I’ve been reading up a bit, so it’s encouraging.

I just have to be patient and do my research and find the right people!

Thanks for your time!

Taking steroids is supposed to promote production of red blood cells. Don’t know if this will be of any use to you, but it might be worth raising it with your doc.

Some good points have been raised. While it would be ideal to find a medical practitioner of some sort experienced with patients with your condition and e.g. supplements, this is relatively easy to do for diabetes and perhaps very difficult for what you have since it is not very common.

  1. At a minimum you need to find a really good hematologist who is up on the most current conventional recommendations, and knows what problems you might encounter. Someone at a major university medical center e.g. UCSF, UCLA, etc. (your profile mentions calif) would be a good start.

  2. You need to do some research yourself so you know what problems you are susceptible to e.g. iron overload, and classes of supplements that might be of help. Not sure how much you know but here is one good place to start Forgive if you already know all this. Also, it is somewhat technical (and may need to register):

http://www.emedicine.com/ped/topic955.htm

  1. From your research you might find supps e.g. green tea and antioxidants that are worth exploring. If you find an open minded doc they will be open to you bringing them abstracts and can supervise your trying these supps. under their monitoring.

A few thoughts from a quck search:

It sounds like you might benefit from agressive antioxidant supplementation:

“alpha-thalassaemic patients suffer from increased oxidative stress and antioxidant deficit, which may complicate the pathophysiology of alpha-thalassaemia.”

: Br J Haematol. 2005 Jan;128(1):119-27.Click here to read Links
Antioxidant deficit and enhanced susceptibility to oxidative damage in individuals with different forms of alpha-thalassaemia.

    * Cheng ML,
    * Ho HY,
    * Tseng HC,
    * Lee CH,
    * Shih LY,
    * Chiu DT.

Graduate Institute of Medical Biotechnology & Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Kwei-san, Tao-yuan, Taiwan.

alpha-Thalassaemia is a common red cell disorder in Taiwan, affecting 6-8% of Taiwanese. Previous studies have shown that reactive oxygen species are generated in increased amounts in thalassaemic red cells. This implies the possible alteration of redox status in thalassaemic patients, which may adversely affect their health. In the present study, the redox status of patients with alpha-thalassaemia trait and haemoglobin H (Hb H) disease was investigated. Lipid peroxidation, as measured by the level of plasma thiobarbituric acid reactive substances (TBARS), was increased in alpha-thalassaemic patients, with the highest level of TBARS in Hb H disease patient. The plasma levels of vitamin A, C, and E were significantly lower in alpha-thalassaemic patients than in controls. The overall antioxidant capacity in plasma was inversely correlated with the severity of alpha-globin gene defect: the more severe the form of alpha-thalassaemia, the lower the overall antioxidant capacity in plasma. Erythrocytes isolated from alpha-thalassaemia patients had lower levels of vitamin E, glutathione, catalase and superoxide dismutase. In addition, these alpha-thalassaemic red cells were more susceptible to hydrogen peroxide-induced lipid peroxidation and decrease in deformability. All these data suggest that the alpha-thalassaemic patients suffer from increased oxidative stress and antioxidant deficit, which may complicate the pathophysiology of alpha-thalassaemia.

PMID: 15606558

There was an abstract for carnitine and one of the other kinds of thalassemia. worth looking into, but I’m not sure of its applicability to your kind of thalassemia.

Hope that gets you started.

sharetrader and ScottL, thank you both for your time and advice!

I am actually fairly knowledgeable about my particular health condition, but definitely any and all knowledge you guys are able to pull up will be a great addition!

The article regarding the prevalence of alpha thal in Taiwanese people is one I haven’t seen yet, so thank you for posting and linking it! I’m actually Taiwanese, so it really hits home for me.

Some facts:

  1. As far as diets go, I’m supposed to avoid foods that are high in iron content because yes, I do have the risk of iron overload.

HOWEVER, after all these years, I’ve concluded that I should just watch that I don’t overdo the iron and make sure that the iron I get is from natural sources - meats and veggies and nuts and not vitamins.

  1. Antioxidants, as ScottL pointed out, are probably a good way to go for me as one of the issues with having thalassemia is that my RBC cell walls tend to be weaker and are more prone to hemolysis and oxidation - whoops.

  2. I am NOT transfusion-dependant - hooray for that! So I don’t need to worry about the extra issues related to that.

I’ll share a rather informative article on Hgb H Disease taken from thalassemia.com .

Hemoglobin H disease is characterized by one functional gene that codes for the production of alpha globins (–/-a). Hgb H disease should be considered in the case of a neonate in whom all of the red blood cells are very hypochromic. These neonates have a high percentage of hemoglobin Bart’s on the their newborn screening results. In older children, this hemoglobinopathy is characterized by moderate anemia with a hemoglobin in the 8 to 10 gm/dL range, hypochromia, microcytosis, red cell fragmentation, and a fast migrating hemoglobin (Hgb H) on electrophoresis.

Hemoglobin H does not function as a normal hemoglobin and has a high oxygen affinity (holds onto oxygen longer making it unavaible for use by the body), so the measured hemoglobin in these children is misleading. Individuals who have Hgb H generally have a persistent stable state of anemia, which may be accentuated by increased hemolysis during viral infections and by exposure to oxidant medications, chemicals and foods such as sulfa drugs, benzene, and fava beans (similar to individuals who have G6PD deficiency). As the red cells mature they loose their ability to withstand oxidant stress and Hgb H precipitates, leading to hemolysis. Therapy for individuals who have Hgb H disease includes folate, avoidance of oxidant drugs and foods, genetic counseling education and frequent medical care. Uncommon occurrences in a child with Hgb H would be severe anemia, cholelithiasis, skin ulceration, and splenomegaly requiring splenectomy. Unlike individuals who have beta thalassemia, hemosiderosis is rare in Hgb H disease.

So yeah.

Thanks again!

I DO have a hematologist, actually, but he’s sort of the sort who would rather me be safe than sorry, which has so far == to “take it easy”. I’ll definitely approach him with the notion and a plan to build my body, but I’m not too sure how receptive he might be to that.

I suppose hoping for a doctor who understands thalassemia (or related blood disorders) and who is also well-versed in the art of body building is too much of a long shot, yes?

At any rate, I’ll be looking up doctors and the like and making phone calls very shortly!

Ha, the title attracted me to this post, and who should I see? :wink: I guess I planted a seed during our chat! Good luck!

Thanks! ;D

You’ve definitely got me motivated more than ever, so thank YOU so very much!

Best of luck to you, too, and it’s so awesome to see you here!


I am in a similar boat, as in I am working against heath conditions, so I can relate, but the bottom line is this: Are you going to train or just sit on your ass and be “normal”?..

If you are going to train, then you will find a way to do so, therefore your only concern is how to maximize your workouts under the limitations faced and try to make them count

Be prepared for setbacks along the way, just deal with it…

Hell yeah I’m going to train! ;D

Sitting on my ass is something I’ve done more than enough of lately.

I fully intend to get the most out of everything and try to make everything count.

Setbacks are something I’m used to, so as long as I remind myself to keep going and keep a chin up, I think I can do it.

Best wishes to you! It’s heartening to see another member here who is also working positively with health conditions like I am.