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Runners: Understand Your Blood Test Results

Recently at Urban Wellness Clinic, we have seen an uptick in runners getting blood work done before increasing their mileage or before heading out to their world championship races. Some of our runners train 120-160 miles a week and that kind of pavement pounding places stress on the body. But while working out and training hard is a stressor the body adapts to, resting after a run makes the immune system that much stronger. Runners are often prone to adrenal fatigue so it’s always smart to be upfront with your doctor about how heavily you’ve been training, because it can make a huge difference in how your blood test results are interpreted! Depending on how recently you ran, for example, we may suggest rescheduling your blood work labs for a couple of days after training to get more accurate results.

I can’t emphasize enough how worthwhile it is to find a health practitioner who knows how to evaluate athletes’ test results—someone who also understands the relationship between cholesterol, thyroid hormones, and iron. This is important because endurance athletes are at high risk for health issues if they don’t have enough HDL cholesterol and iron in their bodies, and if their thyroid isn’t working properly.

Here’s a quick run-down of a few running-influenced workups and what to watch out for:


This test of your hemoglobin levels shows whether you have anemia or a low red blood cell count. Marginally lower levels can be normal if you run because your body produces extra fluid to keep your sweat and blood flowing, which in turn dilutes your red blood cells. But iron-deficiency anemia is pretty common, especially for women, and can make you too tired to run! How to increase hemoglobin levels so you don’t wind up there.  If your hemoglobin is low vs high, your doctor should also test your ferritin.

Ferritin is a protein that stores iron in your cells. If you’ve been tired, weak, or suffering from headaches, it’s a good idea to get it done. When combined with fatigue and low hemoglobin levels, a ferritin deficiency may mean you need iron and should start on a ferritin supplement stat. Here are some tips on how to increase ferritin naturally.


Blood and protein in your urine are warning signs of a urinary tract infection, kidney disease or in the rare event, cancer. Thing is, urinalysis protein (and even blood) can show up for a day or two after a run, skewing your urinalysis’ normal values. So don’t panic. Just try to take a rest before your urinalysis procedure.

Runners are prone to adrenal fatigue with long cardio workouts, so get your blood work checked quarterly.

Creatine Kinase (CK)

This test is used to help determine whether someone has had a heart attack or other type of muscle breakdown. But intense runs that cause micro-tears in your muscle fibers can elevate your CK levels for a day or two—not usually a reason to be concerned. Yet because it makes it difficult for your doctor to tell if you’ve also sustained muscle damage from a heart problem or as a side effect of medication, she may want to repeat the test at a better time. A  creatine kinase normal range u/l in blood serum is 22 to 198 u/l.

Creatinine with EGFR
If you take painkillers as a result of running pain, it can alter the results of this test, which show how well your kidneys are functioning. Too much ibuprofen or other anti-inflammatories can hurt your kidneys. An abnormal result here means you need to cut back and find healthier ways to address your pain, like paying us a visit at Urban Wellness Clinic!

Electrolyte panel
This test shows the sodium, potassium, and other electrolyte levels in your blood. Working out can leave you temporarily depleted, so if have a non-running related complaint, it might be best to do this test another time. But if you often get post run headaches, your doc may actually ask you to run before testing. If your levels are very low afterward, you may actually be over hydrating which can through your electrolyte levels off.

Vitamin D
If you’re experiencing frequent stress fractures, low energy, or insomnia, your vitamin D blood level is important to check. If you’re running outside in the hot sun a lot, you’re less at risk of lacking this “sunshine vitamin.” But if you’re training for the NYC Marathon in October, have darker skin, or are devoted to your sunscreen, your levels could be on the low side. Ideal vitamin D levels can be found here!

Vitamin B12

We get our B12 from meat, fish, diary and eggs, and we absolutely need it to make red blood cells and DNA! Pernicious anemia is caused by a deficiency of B12. Since it’s only found naturally in animal products, vegetarian and vegan runners: watch your levels and start taking a supplement!

I recommend having complete blood work done twice a year, with a follow-up in-between if anything seems off. While it may seem unnecessary, these blood tests can can help ensure you’re getting the most out of those hundreds of training hours, and that your body’s getting what it needs to stay healthy and keep up the pace!

Give us a call either pre or post-blood work for holistic health support designed with you in mind: 212-355-0445 or

Best in health,

Dr Emily Kiberd