Adverse effects of anemia on the trail

Anyone out there know anything about possible symptoms of anemia while hiking? We camped out last weekend .... bitterly cold Friday night, and though I felt warm in the bag most of the night, only a tiny bit chilly when I woke in the morning, I felt suddenly very unwell as we broke camp Saturday morning. Some research has led me to think maybe I was suffering from anemia, but I would love to hear from anyone with a med. background or anyone who may have experienced it themselves out on the trail. I'm not looking for a diagnosis here, just some ideas, that's all.
Thanks in advance for any information,

Chris -

Staying warm/comfy after a bitterly cold night is going to tap your resources, so my first hunch would not be anemia - I'd be looking at the usual suspects, which is maintaining adequate hydration and glucose. Before you broke camp did you have something to drink? Coffee/tea/chocolate/water and something to eat as well? If not, then should you be in a similar situation again you might consider munching on something and something to drink even before you get out of your bag - maybe 20 minutes before you ask your body to actually do anything.

Kevin,
Thanks for the reply. Having never backpacked/camped out in that kind of cold before, I honestly didn't know what it would take to fuel my body. I did heard quite a bit afterward about how what I typically eat when I hike is not enough to sustain my energy on overnights in particular (and rightfully so, I would add), and I guess I know in a very hands-on way how very true that is now. I felt warm most of the night, truly, and the hike up was a pretty short, relatively easy one, so going on those cues alone and judging by past experience, I thought that I ate and drank enough, but apparenlty not. I had half of my thermos of herbal tea and a Cliff bar maybe 25 minutes previous to feeling very suddenly ill. I understand I may be more succeptible, as well, being a vegeatarian ... I've started taking my supplements again just as a precaution. And in the future I'll have to plan better and eat and drink more, obviously. I will try it before I even get out of the bag, too, as you suggest. Thanks again.

"bonking" while simply warming air up...

Kevin's right...don't ya just hate bonking without even having exercised???!!! Actually, for most of us, our levels of sugar and glycogen (a kind of starch we make and store that can be converted quickly to sugar) are lowest early in the AM. If it was a cold night, you were probably on dead empty. Run completely out of glycogen in your muscles and liver, and voila- instant unwellness. It takes a while for energy to get from your stomach to your bloodstream, unless you eat/drink almost pure sugar (like OJ). So do what Kevin says and you'll be OK. When it's really cold, you sometimes even need to get up and eat in the middle of the night. Something with protein/complex carbohydrates is good, as it lasts longer, even though it takes longer to absorb. I like clif bars as long as they are not ice blocks, but they take an hour or so to get to the cells where they're needed most.

Happy eating!
Weatherman

Chris -

Don't discount that you might have eaten something that didn't agree with you, or even a bug that chose that time to make you feel nauseous.

When I'm in those kinds of very cold sleeping conditions, it's hard to overeat because my body's metabolism is cranked up to stay warm. I'm also a vegetarian, so I try to eat calorie-dense stuff that I really like, like a cashew/mini-morsel chocolate chip gorp, Snickers bars I stuff under my armpits so they won't freeze, etc, and you might find it necessary to have a candy bar in the middle of the night. The Snickers aren't the greatest thing in the world for you nutritionally, but they have alot of calories, including fat, and I love 'em so will eat them. The key is to to have alot of calories you'll eat even when you'd rather not. And the fluids are so necessary to move the nutrients around as well as transport heat.

The possibility of eating something that didn't agree with me did enter my mind, especially since I have had occassional issues with food allergies (very isolated incidents and items that now tend to be easy to stay away from, luckily) and it did sort of feel similar to one of those incidents. It's funny that you mention cashews and candy, though, because I normally don't eat stuff like that and I had quite a bit (probably 4 servings??) of a homemade trail mix with cashews and M&Ms the previous day. Jim's point to me afterward was that I hadn't really eaten much more all day besides a couple of Cliff bars and a small piece of omlette. The anemia question came up because of some other pieces of the puzzle that came up as I mentioned what happened to a couple of other women I know who have backpacked extensively and who are also vegetarian. Interesting. Thanks you so much for all the input.

To expound on what weatherman mentioned, I have noticed a big difference when deviating from the norm where nutritional requirements are concerned. It's why I shy away from the freeze dried meals and try to bring more of what I'd have at home. I can eat them, but they make me feel a little "off" in short order.

Extreme cold is a whole different world from just regular winter camping. I regularly have some Gu and water handy, and try and drink more than usual because I know I'm using more energy to keep my body warm.

I always take supplements before and during camping or hiking, it helps "straighten me out" nutritionally as I'm using more than I would ordinarily.

In general it is unlikely to have sudden onset of symptoms from anemia unless the cause is sudden, such as bleeding. The most likely symptom of a more longstanding anemia during exertion would be shortness of breath, as your blood cells are what carry the oxygen from your lungs to your muscles and the rest of your body tissues. You would more likely notice the huffing and puffing during the hike up than being suddenly drained.

Hypoglycemia, hypothermia and other illnesses would be more likely to cause more sudden onset symptoms. I am a big fan of Gels for more acute bonking but they should be followed by longer lasting protein and complex carbs. I don't know about Cliff bars especially in terms of fat and fiber. Fat tends to slow absorption of the foods it is with and fiber makes the gut work more and may also slow absorption. Losing heat all night may have robbed you of your stored glucose and glycogen as those above have duly noted - your body will use it to "stoke the fire." Hope this helps.

It's been quite a while since I was taking my supplements regularly, and I've been perfectly fine, but I'm taking care to start taking them again just as a precaution. Jim actually did bring some of the meals ready ... ummm almost ready, to be correct .... to eat and if I hadn't declined trying them it would've been the only hot stuff I would have had to eat that evening besides my tea ....Despite the fact that they did not get rave reviews, I wonder now if that in itself was a mistake. I'm not sure I'll ever know exactly what happened but this wasn't simple "bonking" .... I'm pretty damn tough, and I was ILL .... and it came on like a freight train really.

It may not be anemia, it may be a vitamin B deficency. The only way to find out is to get blood work done to rule out anemia or vitamin deficencies. I do speak with a medical background and my Aunt is a vegan who sufders from a B deficency because of her choice. It's not too uncommon for vegans to get low on a b, I think it's 6 but I am not sure. It seems that your dietary choice, while being probably much heathier in the long run, does not allow you enough fats to burn for sustained cold and can leave you bonked easily, from what I've gathered from other medical people and dieticians. I have heard of some using olive oil as a suppliment to keep the fats up and stay vegan. I don't know how well it works or how tasty it is since I live off junk. I'd love to be able to change my diet and eating habits, but in my line of work as a paramedic you eat what you can when you can. It amazes me how long my crew can survive on Pop Tarts and coffee. Not always very healthy.

Chris -

When you mentioned that something similar happened to women friends, then it makes me wonder all the more about adequate levels of hydration. Nowithstanding the body's need for glucose and glycogen, and B vitamins, it's been my observation/experience that it's so much harder for women to stay hydrated given the anatomical differences and cold weather. Have I said that delicately enough? And yes, I agree with you 100% - it isn't fair, men have it easy, men don't know how difficult it is, etc, etc. Maybe we (men) will in the next life. But, as I hear my own women hiking friends talk, they frequently say how much better they feel as they learn they simply have to drink more, and at regular intervals.

And mediclimber - believe it or not, you can get organic pop tarts. Last year I was with a group of friends in an Oregon supermarket stocking up for a trip to "the Hood". The market is part of a small chain (People's Choice if memory serves) which carries organic as well as "regular" items, and a lady friend saw me reach for a box of the organic ones. She burst out laughing, and pointed out (probably correctly) that organic pop tarts were an oxymoron.

Busted again.

As most people have said, it is highly unlikely that you had anemia. You would have shortness of breath and a high heart rate. It is more likely that you were experiencing some dehydration. By the sound of it, you were drinking a lot of tea, which is a diuretic and would cause further dehydration. Also dehydration can cause your stomach to feel uneasy, and you can have nausea/vomiting, which is why many dehydrated people are unable to tolerate oral intake and receive IV fluids.

However, there are some other concerns. Anemia is mostly caused by blood loss, certain deficiencies, genetic causes, and hemolysis. Vegetarians and vegans often do not get enough vitamin B12 which is needed for DNA synthesis. This causes the red blood cells to become enlarged. However, you would notice other problems with B12 deficiency including neurological changes, fatigue, and other symptoms of anemia without even exercising. This does not happen in an acute setting. So, I don't believe that you were experiencing symptoms from B12 deficiency.

Another cause that can occur is hemolytic anemia, where the red blood cells are being damaged. In rare cases, there have been times where excessive damage to capillary beds, such as repetitive pounding on your feet when hiking, that could cause trauma to the red blood cells. Although it can be profound, this kind of hemolysis is usually mild, and you shouldn't experience many symptoms of anemia, but what you might notice is blood or a pinkish color in your urine. This is a very RARE, and most people have other problems like vasculitis.

So, next time you go out, I would suggest proper nutrition and hydration. Try to avoid tea as it will further dehydrate you.

In summary Chris eat more than Cliff Bars and M&M's, use them as a supplement. Also do not refuse to eat breakfast when offered, you can not drive your car without gas, right? Would hate for you to get all worried about this deficiencies and that one, really feel that it was either a bug or not staying hydrated or eating enough. When I was out in the Rockies for 2 months straight in winter, we used to eat these speed balls before going to bed at night, without eating them you could not sleep through the night, woke up freezing. What they were was a glob of butter rolled in coco, went down real easy, and it gave your body the fat it needed to burn through the night. I never woke up cold on that trip but also gained 15 lbs. lol.
I thought "bonking" was done in the privacy of your own home and was not spoken of on this type of site, lol.

Mediclimber (medical background) mentions olive oil. Local old folk (experience and wisdom) are known to do shots of olive oil.

It would be helpful to know what you mean by not feeling well.

If you had M&Ms and a Cliff bar for breakfast, my vote would be reactive hypoglycemia. This is basically an epinephrine reaction: lightheadedness, rapid pluse, nausea - you feel bad. It would go away after eating a bit more sugar or when the complex carbohydrate part of the Cliff bar was digested.