Running With Gilbert’s Syndrome

I slacked off on my blogging last year because I hadn’t been running much and didn’t feel there was anything worth writing about. I haven’t done a race since last June, but am getting back on track now that I’m healthier. I’ve been training for a few spring races and am looking forward to the Bataan Memorial Death March (26.2 miler) later this month and the Jemez Mountain 50 Miler in Northern New Mexico in May.

Bataan Death March 2017

Last year was a rough year for me health wise. I began feeling bad last spring and decided to back off on my running in the summer to determine what was going on. I was having a lot of fatigue, dizziness, irritability, insomnia, chills, asthma and brain fog. At the time I thought I was having food sensitivities, but my doctor thought it was acid reflux. Doesn’t every male over 50 have acid reflux? Anyway, he put me on some acid reflux meds and things went downhill from there. By October I became very sick with a low grade fever, chills and high counts of liver enzymes, bilirubin and ammonia. 

Jemez 2017, I barely made the last cut-off time 

After an ultrasound, CT scan, MRCP (a type of MRI) and 50 blood tests, a liver specialist determined that I had suffered a drug induced liver injury. Fortunately the liver is an amazing resilient organ and, unless you bombard it with alcohol, can regenerate and heal itself. In addition, the specialist determined that I have Gilbert’s Syndrome which makes my body more susceptible to adverse drug reactions and less tolerant of toxins. I became allergic to aspirin and other NSAIDs (ibuprofen) when I was around 35 years old so only take acetaminophen for fevers and pain. Of course this is also bad for the liver.

Tibetan Prayer flags on N. Franklin Peak

Gilbert’s is a genetic condition where people are born with less of an enzyme that converts bilirubin to bile. (Bilirubin is a waste product from dead red blood cells.) My bilirubin count is always about twice a normal person’s. Most people don’t know they have the condition and the main symptom is jaundice when they are sick. Unfortunately though, some of us experience many other symptoms including those I mentioned earlier. 

I’ve always suffered hypoglycemic reactions (low blood sugar) to some foods and noticed that I was becoming more sensitive to sports drinks, gels and other sugary foods during races and training. Another problem I've experienced over the years is chills and night sweats following long races. I never knew why, but now believe it's because high levels of ammonia build up in our bodies when we run long and the liver and kidneys are supposed to convert it to urea where it's then excreted through our urine. However, a secondary way to rid ammonia if the organs can't keep up is through sweating. Of course ultra-marathoning puts great strain on the body including the liver so people with Gilbert's Syndrome are supposed to avoid fasting and strenuous exercise as well as get lots of regular sleep. That recommendation doesn’t sound conducive to ultra running does it? Well, I’m going to try anyway!

**Intermission**

Medical stuff can be very boring so here are some bird pictures to make this post more enjoyable. (I like to bird watch when I can’t run.)

Thrasher taking a drink

Lesser Goldfinch

Scaled Quail

Northern Shoveler pair

Do you feel calmer now?

Per my doctor’s recommendation, I’ve been on a no grain, no dairy and low sugar diet that you could call quasi paleo. I now totally stay away from processed foods and watch closely what meds I take. I’ve had to rethink my race and training nutrition strategy and have been experimenting with running foods. Gels and sport drinks are out as well as crackers, bread, cookies, etc. I’ve substituted potatoes for grains and have been running with boiled salted potatoes, potato chips (coconut or avocado oil), dried fruit, fresh fruit and almond stuffed dates. My protein comes from hard boiled eggs and a little chicken or turkey.

Franklin Mountains, El Paso, TX

My training is going well and I’ve regularly been going up to the N. Franklin Peak (7192’) including a double ascent. I also ran 26 miles around the Franklin Mountains which is an epic loop that is part of the Franklin Mountain 50K and Lone Star 100 courses. I have several water caches placed strategically along the route that enable me to stay hydrated when I do this run several times a year. I tried out my foods on my run and was able to keep my energy up for most of it. I started to bonk toward the end while climbing up to Mundy’s gap (6000’), but ate some dried apricots and a few dates which carried me the rest of the way home.

The view from N. Franklin Peak

Someone had a lot of time on their hands

Overall, I feel much better now. I was able to bounce back quickly because I was in good shape having run a lot of ultras in the past. I also attribute my success to the low sugar and lower carb diet that I’ve been eating. My wife, Cara has been eating this way for several years and has been a godsend. She cooks wonderful meals for us and has taught me what foods to avoid and what to eat. Our world is full of horrible food choices and we are over medicated so it’s no wonder I had a liver meltdown. Toxins, preservatives and chemicals are in everything so it’s hard to avoid them, but with effort it is possible to eat clean for your health. 

I haven’t planned a very demanding race schedule this year until I see how things go at Bataan and the Jemez 50. These races will be the true test to see if I can continue running ultras. Time will tell if I have any more hundred milers left in me. Regardless, I will keep running in some capacity as long as I can. 

See you on the trail.