Elevated bilirubin level more OR less common in barefoot/sandal marathoners?

I am not sure if this should go in Ask the Doc or Runners forum or where is best! :) ... life is so wonderfully holistic!

I have had some blood work done (April 10) for my regular check ups (unrelated to sports, running) and all my levels were fine, except for my total bilirubin which was a 4.44 (while training, but a couple months after doing 3 marathons in 3 consecutive weekends in January).


I had my bilirubin tested a month later (May 10) & it had dropped to a 3 (and about 2 weeks before my last marathon this weekend). I did a marathon on Sunday (May 22) & had my total bilirubin checked again today (May 24) and it went up to 3.9. I will plan to test it in a couple weeks. I have no fatigue, signs of jaundice, etc. ... classic symptoms of high bilirubin or liver not working well. I did have some blood in my stool a couple times in Feb or March, but not sure if it is related at all to this subject.


I have read repeatedly that long-distance running causes increases in the total bilirubin numbers which can be accounted for by hemolysis and hepatic disturbances, etc. ... the impact of running playing with red blood cells.


I train barefoot & in 4mm sandals (Luna Venado) … and do most of my marathons in these sandals. Do you think barefoot/sandal runners are more or less susceptible to higher total bilirubin counts with “mechanical trauma” when running many miles?


I wish I had done blood tests when I was running in shoes!, but I know that there are too many variables & factors to really determine anything from one person’s own experience.
 

Attachments

  • Effects_of_long_distance_running_on_serum JAPAZ .pdf
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  • Mechanical hemolytic anemia - Wikipedia, the free encyclopedia.pdf
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I don't think your being barefoot or in minshoes has anything to do with your levels. I think that's something common to runners in general.
 
I was considering the "impact induced effects" & the feet themselves while running and the relationship to red blood cells that then effect total bilirubin level measurements. I was curious that if we run with less impact than when wearing clunky shoes, then we should have less red blood cell "trauma" and lower total bilirubin level ... that is my simplistic thinking. id est, my total bilirubin levels would be even much higher if I ran with shoes.

from the attached articles ....
"Red blood cells, while flexible, may in some circumstances succumb to physical shear and
compression. This may result in hemoglobinuria. The damage is induced through repetitive mechanical motions."

"Repetitive impacts to the body may cause mechanical trauma and bursting (hemolysis) of red blood cells. This has been documented to have occurred in the feet during running."

"Runner’s macrocytosis is a phenomenon of increased red blood cell size as a compensatory mechanism for increased red blood cell turnover. The impact forces from running can lead to red blood cell hemolysis and accelerate red blood cell production."
 

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