| Test | Result | Optimal range | Status |
|---|---|---|---|
| Ferritin | 8 ng/mL | 30–150 ng/mL | Low |
| Vitamin D, 25-OH | 21 ng/mL | 40–60 ng/mL | Low |
| Vitamin B12 | 310 pg/mL | 500–900 pg/mL | Low-normal |
| TSH | 2.1 mIU/L | 0.5–2.5 mIU/L | In range |
| Hemoglobin | 12.9 g/dL | 12.0–15.5 g/dL | In range |
| Supplement | Dosage | Timing | Duration | Evidence | Rationale |
|---|---|---|---|---|---|
| Iron bisglycinate | 25 mg | Evening, away from coffee/tea and calcium; pair with vitamin C source | 12 weeks, then re-test | A | Ferritin of 8 ng/mL indicates depleted iron stores — the most common driver of fatigue and performance decline in female endurance athletes. Bisglycinate form chosen for GI tolerability at repletion doses. |
| Vitamin D3 + K2 | 4,000 IU / 90 mcg | Daily, with a fat-containing meal | 12 weeks, then re-test | A | 25-OH vitamin D of 21 ng/mL is below the functional target for bone health and immune resilience under high training load. K2 included to support calcium trafficking during repletion. |
| Methylcobalamin (B12) | 1,000 mcg | Morning, sublingual | 8 weeks | B | B12 of 310 pg/mL is low-normal in the context of a predominantly plant-based diet and elevated training volume; repletion supports erythropoiesis alongside the iron protocol. |
Evidence grades: A — consistent RCT/meta-analysis support · B — limited trial evidence · C — mechanistic or observational only.
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