Sunday, June 2, 2013


2 weeks after the event that was TNF100, I've had some time to reflect on what worked and what worked didn't.  But instead of  lamenting over the 'what-ifs',  I've been focusing on how to best facilitate my recovery.  

After having several days of feeling very much below par,  I had some blood tests and a general check up performed five days post race.  At this stage I was concerned about my kidney function as I was still more than 5% above my race starting weight and had notable peripheral oedema. I also had investigations into gastric ulceration as race day nausea and reflux hadn't settled.  As an athlete and a Health Professional, I am acutely aware of the impact of ibuprofen on kidney/renal function and gastric ulceration and refuse to take anything in the NSAID family of pharmaceuticals pre/during/post race or at all.  Another consideration is that paracetamol metabolism is undertaken primarily in the liver, so I also avoid this group of drugs as well.

General systemic check showed normal BP for me (110/50) and HR 55 with normal rhythm.  During the event I had several episodes of SVT (HR: 180) that lasted for around a minute and gradually reduced with a gentle carotid rub, so a normal rate and rhythm was good news.   The results of my blood tests came back with surprising results.  All electrolytes, vitamin D and B6/B12 (specifically), calcium and iron levels were normal (good news considering a near vegan diet!).  Kidney function was normal and in fact, optimal.  No evidence of gastric ulceration either. The outliers were my liver enzymes, with nearly all being elevated above normal.  

I've done some empirical and anecdotal research since being given these results and have found elevated LFT's seem to be present in some athletes following long distance events and also after high intensity events.  The liver seems to be bombarded with toxic by-products of extreme exercise such as skeletal muscle breakdown (rhabdomyolysis) and lactic acid and is unable to process and metabolise these toxins effectively.  Not only is the liver trying to keep processing and suppling energy to the working muscle, it also having to deal with becoming loaded with toxic by-products.  The end result is liver dysfunction. (most notable causes of liver enzyme dysfunction is infection, obstruction, cirrhosis, fatty infiltration, myocardial stress, medication use, alcohol abuse and skeletal muscle trauma).  So, given this, the most likely culprit is racing induced muscle trauma.  
The Liver: time to pay more attention to this vital organ

However, I, along with over 30% of surveyed TNF2013 respondents ( used Hammer nutrition as their primary source of race day nutrition.  I was one of those respondents.  These products worked well in training with my GIT tolerating them very well.  Race day was another story though!!  On searching the USA Hammer Nutrition website, a marathon athlete posted having raised LTF's post event and thought that there may have been a link to the products being used.  He ceased the Hammer products, had bloods performed and his LFT's returned to normal levels.  As a trial he recommenced the products and had further blood tests performed and ....voila....a return to elevated LFT levels.  Co-incidence? Maybe.  Admittedly, one case does not mean the results are the same as a double-blind ramdomised controlled trial.  But in my case....definitely food for thought.

Specific recommendations for liver recovery:

  • No alcohol 
  • Review/cessation of  medicines, supplements
  • Nutrition for optimal liver function: broccoli, kale, apples, beets, garlic, cauliflower
  • Specific liver herb: milk thistle
  • Low grade, low level exercise only:  so as to not cause skeletal muscle trauma (I did see that the recommendation by Hammer Nutrition was for 6 weeks complete rest for the above mentioned athlete and then re-test)...that length of rest is probably not going to happen in my case :-P
  • implement the above and see what the repeat bloods show.

Lessons Learned:
  • Listen to what your body is telling you during won't the same as in training
  • Act early in making changes to hydration, nutrition, pace and nervousness levels
  • Don't persist with what's not working
  • Have more fun with running!!
  • Hindsight is a wonderful thing!!!

Mummy and Maddi being bears in the woods at a local running event!

“Struggling and suffering are the essence of a life worth living. If you're not pushing yourself beyond the comfort zone, if you're not demanding more from yourself - expanding and learning as you go - you're choosing a numb existence. You're denying yourself an extraordinary trip.” 
― Dean KarnazesUltramarathon Man: Confessions of an All-Night Runner