A silver lining

08 Feb, 2025

Exactly a year ago I reached a breaking point. Working for just two hours per day exhausted me, and I became overwhelmed by the smallest of tasks. I often came home and faceplanted into my bed, laying in silence to calm myself down.

Worst of all was my hair: I was shedding clumps of it every day, and what remained on my head was terrifyingly thin. This prompted me months prior to get a haircut much shorter than I was used to, but the problem only worsened. I had no idea what was happening to me. I take my health very seriously, so what gives? Was this some sort of phase?

I became desperate for answers after I was suddenly tasked with watching my friend's dog and felt the world crushing me.

Like anyone with a burning medical question, I turned to anecdotes on Reddit to figure out which tests I should take. I reviewed my bloodwork, and one measurement stood out to me. Ferritin: 21 ng/ml. This was in range on the test, but just barely.

Could this be the source of my problems? I scoured the Internet for more information on low ferritin levels. My symptoms matched what I was reading. Next in my self-diagnosis was to identify a potential root cause. Truth be told, I had felt poorly for at least eight months at this point, maybe even more.

Initially, none of this made sense because I didn't think I fit the stereotype of someone with iron deficiency or anemia. I am and was not vegetarian or vegan, and I intentionally eat red meat a few times per week. The only major change I could recall within this timeframe was ramping up my running mileag. A two-year stint of cross country in high school inspired me to continue running longer distances for a bit in college before I replaced it with lifting, only to put on my running shoes again years later.

It turns out that repetitive pounding from running destroys red blood cells, especially on concrete. Foot-strike hemolysis. This has to be it, I thought.

I went to my university's student health clinic and presented my test results to a (male) doctor who was much more interested in what I did for a living. He attributed my anxiety, overwhelm, and hair loss to my PhD program although I was in my fifth year of my studies and already accustomed to the workload.

Your ferritin is low but still within range, he assured me. You're also not anemic.

Barely, I thought.

He didn't tell me to stop taking the iron pills I started taking, but he also didn't think they would make a significant difference.

Much of the medical community considers a ferritin level of under 30 ng/ml to be an absolute iron deficiency.¹

Frustrated, I knew I had to try solving the problem by myself.

Slowly, I got better with supplementation. Of course, there were lots of ups and downs.

At some point I even thought I had to see a hematologist, and I started to wonder whether I should refrain from an upcoming international trip I had planned. After about a month of taking the supplements, my body reacted freakishly, manifesting in such anxiety and breathlessness that my friend had to take me to the ER. Yet, everything came back normal, and my hemoglobin had even increased.

I recovered a bit and managed to go on the trip. Though I didn't bring enough iron supplements with me, thinking I couldn't get spiral much further in three weeks, I found myself relieved to find a store selling them after I arrived in Yerevan. I came back and requested a different doctor, who was incredibly apologetic after I described how dismissive the previous one was toward me.

But really, no doctor helped me. Only iron supplements and refraining from running did. My hair grew back. Color returned to my face; I didn't notice before how pale I had become. I began to feel like a real person again. And again, this is something I didn't realize until I actually started feeling better. When you feel awful, it just becomes the norm.

Overall, it was a hellish experience and something I regret not solving sooner. My iron deficiency robbed me at least a year of productivity, which I to this day have never admitted to my research advisor.

I also had to stop running for a long time in order to replenish my iron stores. Nowadays I run a few times per week, but nothing crazy.

The story of my iron deficiency is a lengthy prerequisite to explaining something positive that came out of this in hindsight: To replace running, I got a bike. My first one since childhood. And it turns out I love cycling.

Within the past year, I started biking all around my city. My quality of life significantly improved by cutting my commute time by more than half. I even went on my first bike trip in the fall, riding all the way across my state in just a few days. A couple months ago, I purchased an indoor trainer so I could continue riding in the winter and become even fitter on the bike. Now I daydream about embarking on another bike trip, maybe even across Europe someday.

If you asked me a year ago if I would ever become a cyclist, I would have thought you were crazy. But I doubt I would have ever consistently ridden a bike in my adulthood had it not been for my iron deficiency. In a weird way, I am grateful for what happened to me.