An interview with marathoner and pharma expert Elena Znova on the supplements she takes to boost her running and recovery
DISCLAIMER: the supplements discussed below are specific to Elena’s program. Please talk to your doctor before taking any supplements.
Elena Znova first started her running journey 10 years ago as a way to try to relax in the evenings after a stressful day as an MD, ER surgeon in Moscow. She tried swimming, dance, and meditation, but none offered her the same mental and physical release that running did. Although she struggled during her first 5K and had to walk halfway, she kept running, and ran her first half marathon a few months later. She fell in love with racing, and has run 11 marathons to date, typically racing 3 times a year (PB 3:13:02).
As she continued her running journey, Elena developed a passion for mental health, food supplements, and how to live a healthy lifestyle. She switched from surgery to pharmaceuticals and has been focused on this area for the last 12 years. Switching to Pharma also led Elena to move all the way to the US, a stressful life event in itself, and once again running came to the rescue.
In our first blog post of the series we discussed supplements for runners and how select supplements can aid us as runners when it comes to both training for our next race and maintaining between races.
Why do we need supplements for running?
As a runner who runs 3 marathons a year, and 50-60 miles a week during training season, I realized that runners need extra supplements because what we are putting our bodies through is very hard, and we are using more micronutrients than the average person. I have annual check-ups to ensure I have enough iron, protein, and vitamin D. I've been doing vitamin supplementation for at least ten years, and I’ve never seen any overdosage in my blood work. I was anemic (low iron) at least twice during this period of time.
What types of supplements do you take and why?
First, I think it is very important to have clinical studies and data supporting any type of supplement recommendation. I personally take 10 types of supplements – Vitamin C, Vitamin D, Zinc, Glucosamine, Omega 3/6/9, Collagen, Iron, Magnesium, B12, and Probiotics.
Wow! Ok let’s start with Vitamin C, Vitamin D and Zinc. Why are they important?
Vitamin C is critical for metabolism, collagen production, and boosting the immune system. But this vitamin breaks down easily. I take a liposomal form of Vitamin C which is better for the body to digest.
Vitamin D supplement is important especially for women because most women are deficient in Vitamin D. If you are in the sun, the body will produce it naturally, but most people do not get enough sun, especially in the winter months. For women, Vitamin D is critical because it is part of our hormones. Without Vitamin D, the body cannot build estrogen. Menopausal women who are vitamin D deficient will have problems with bone density. It is crucial to remember that once you are already deficient, no supplement will help. I think women should start regular vitamin D supplementation once they turn 35.
Zinc is a critical element of our immune system and builds our endurance. We run out of it quickly, so supplements are helpful here.
Zinc can help support immune function and reduce the risk of infections. Zinc also is involved in protein synthesis, which is essential for muscle repair and recovery after exercise. Adequate zinc intake can help speed up the recovery process and reduce muscle soreness. As one of the components of energy metabolism, zinc is very important for endurance athletes. Studies have shown that zinc supplementation can improve endurance performance in athletes. Last but not least, we need to remember that running can cause inflammation in the body, which can lead to muscle damage and delayed recovery. Zinc has anti-inflammatory properties that can help reduce inflammation and promote healing.
However, too much zinc can be harmful to the body. The recommended daily intake of zinc for adults is 8-11 mg per day for women and 11-15 mg per day for men.
What are glucosamine & chondroitin and why do we need it?
Glucosamine and chondroitin are two natural compounds that are commonly used together as a dietary supplement to support joint health. Glucosamine is a natural amino sugar that is found in the body and is involved in the formation and repair of cartilage, the flexible tissue that cushions the joints. Chondroitin is a natural substance that is found in cartilage and is believed to help maintain the structural integrity of the tissue.
Glucosamine and chondroitin supplements are often taken together to help support joint health and reduce joint pain and stiffness. Some runners take glucosamine to help ease knee and joint pain. I take a Glucosamine chondroitin supplement with MSM (Methylsulfonylmethane) to help build healthy tissue and support collagen growth. It was also part of my support therapy when I dealt with IT band syndrome after running the Chicago Marathon in 2021. It was a combination of physical therapy, food supplements and working with a running coach during this time, but I did my Boston Qualification in 6 months after that while recovering from the IT band issue.
Speaking of joint health, collagen powder supplements have become popular. What does collagen do?
Collagen is a protein that is found in the body and is a key component of connective tissues such as tendons, ligaments, and cartilage. When we take in collagen as a supplement, concentrated acids in our stomach break it down into fragments, which helps our body to build our own collagen using these fragments. Some people don’t feel the effects of collagen supplementation because they are missing other factors that are needed to build collagen, such as Vitamin C.
Running can put a lot of stress on the joints, which can lead to wear and tear over time. Collagen can help support joint health by promoting the growth and repair of cartilage, which cushions the joints and helps reduce friction. Collagen can help improve the strength and flexibility of tendons and ligaments, which can reduce the risk of injury during exercise. As runners, we spend a lot of time outside, under the sun or in a cold wind, so our skin condition can suffer a lot. Collagen is also important for skin health, as it helps maintain the elasticity and firmness of the skin.
Tell us about the different types of Omega supplements and which one do runners need?
There are 3 types of Omegas – 3, 6, and 9. Omega 3-, 6-, and 9- are fatty acids that help support the cardiovascular system and aid in reducing inflammation. Omega-3 in particular, have antioxidant, anti-inflammatory and cardiovascular and cognitive function benefits, and can be found in fatty fish like salmon. I personally supplement with all three omega 3/6/9 and try to have a balance between EPA, DHA, and DPA.
Iron deficiency is talked about a lot in running. Why is iron so important for runners?
The lifecycle of red blood cells is shorter in runners because of the constant pounding on our feet. A lot of runners end up being iron deficient but don’t know it, especially female runners because we lose iron through menstruation as well. Iron deficiency can lead to feeling tired and short of breath.
But we also need to be careful when it comes to iron supplementation because if we take in too much iron, it will speed up aging.
A blood test is definitely needed to check iron and ferritin levels before taking any Iron supplements. Low ferritin level is a precursor to iron deficiency. If ferritin levels are too high, that means something in the liver is not working properly and excess iron in the body can mean the body is not processing it well. If test results show that you need iron supplementation, you may need to take it for 3 to 6 months to get back to normal levels. I take iron every other day (not every day because our ancestors did not eat meat every day) for 3-6 months once a year. Excess iron levels can lead to constipation. Iron should be taken with Vitamin C and B12, which increases absorption by up to 30%. Make sure to get the iron supplement in before noon and take it with food, for best absorption is this is when your digestive system is operating at its peak. Do not take iron with caffeine, dairy, or any juices because the acid in the juices impacts absorption.
We see a lot of runners/endurance athletes on social media posts that they eat a steak before a big race. Can we just get it from food?
If you have iron deficiency (once again that has to be confirmed by your doctor), it is hard to guarantee you will get enough by eating red meat. The reason we take supplements is because it is hard to control how much iron is in that piece of red meat – we do not know how the animal was raised, or what the animal ate. With supplements, it is more controlled, and we know how many milligrams are in each serving. Sometimes, iron deficiency isn’t caused by lack of Iron itself, but lack of vitamin B12, which helps to consume Iron properly. Iron complexes usually have B12 in them.
Magnesium is a popular supplement for runners as well. What does it do?
Magnesium is one of the most important supplements for runners. It helps with muscle cramping, which is when the muscle cannot relax after contracting. There are 6 different types of magnesium – one type of magnesium is better for some activities than others. I rotate different types of magnesium.
Here are a few types of magnesium that may be particularly helpful for runners:
Magnesium citrate: This form of magnesium is highly absorbable and can help support muscle function and reduce muscle cramps. It is also known to have a mild laxative effect, which can be helpful for runners who experience digestive issues during exercise.
Magnesium glycinate: This form of magnesium is also highly absorbable and is less likely to cause digestive issues than other forms. It can help support muscle function and reduce muscle cramps, as well as promote relaxation and improve sleep quality.
Magnesium malate: This form of magnesium is bound to malic acid, which is involved in energy production. It can help support energy metabolism and reduce fatigue, making it a good choice for runners who need an extra boost during exercise.
It's important to note that while magnesium supplements can provide benefits for runners, it's also important to consume magnesium through the diet by eating foods such as leafy green vegetables, nuts, seeds, and whole grains. As with any supplement, it's important to talk to your doctor before taking magnesium.
Magnesium also helps keep us calm, which is important for our mind and especially before race day.
Tell us why you take B12 and Probiotics?
B12 is a cofactor that helps in the processing of vitamins, creating enzymes in the digestive system, so it affects how we digest and absorb iron. Please see more on that above.
Vitamin B12 is also involved in the production of red blood cells, which carry oxygen to the muscles. Adequate vitamin B12 intake can help improve oxygen delivery to the muscles, which can increase energy production and improve endurance. It is also involved in the production of ATP, which is the primary source of energy for the body and can help reduce fatigue and improve mental clarity during exercise.
Probiotics are good bacteria that help improve your gut microbiome and contribute to better gut health. A healthy gut is important to overall health, especially if you have stomach problems during exercise.
What do you think of taking multivitamins vs all these supplements?
I personally do not like multivitamins. The types and doses of each vitamin vary depending on the complex you take, and some of them don’t work well together. Also, often, the manufacturers will use the cheapest form of vitamins in a multivitamin complex, like magnesium oxide for example.
Should I take vitamins with food or on an empty stomach?
It depends! First of all, talk to your doctor because some health conditions need a special diet regiment. Some supplements, like magnesium or probiotics, can be taken on an empty stomach or before bed, but others, like Iron, must be taken with food before noon, or you might get nauseous. Many supplements are meant to be taken with food and work better with food.
I’ve noticed some athletes are taking pre-workout supplements. Do you recommend these?
A lot of athletes will take L-carnitine or other amino acids before a workout to increase their metabolism, and give the body extra support of energy. Professional athletes who exercise 2x a day, 7 days a week may need this supplement because they push their bodies far beyond normal. For a non-professional runner, I don’t think this is really necessary.
What do you think about ketones?
The little I know about ketones is that they are produced by the liver when the body is in a state of ketosis, which occurs when carbohydrate intake is restricted and the body begins to burn fat for fuel. For runners, ketones can provide several potential benefits, including improved endurance, reduced fatigue, and faster recovery. It's important to note that while ketones can provide these benefits, achieving a state of ketosis can be difficult and may not be appropriate for everyone. It requires strict adherence to a low-carbohydrate, high-fat diet, which can be challenging for some people. I personally don’t take ketones because there is not yet enough clinical data to support it. Much of the data on ketones is based on research done on children with epilepsy. It is hard to find data on healthy adults for 10 years. I don’t recommend a keto diet for runners because the body is in a constantly acidic state, which has an impact on other organs.
Should we increase the amount of supplements taken during the training cycle?
It depends on the type of supplement. For vitamins C, D, and zinc, there is no need to increase from normal levels during the peak training period. You may want to increase glucosamine and magnesium during peak weeks when you are running the most miles. It would depend on your test results and your doctor's recommendations to see how much is needed for iron.
When should we start taking supplements?
35 is the age when we should start thinking about supplements. After 40, we need to supplement if we want to continue performing for the next 20 – 30+ years. Other lifestyle choices are important as well – for instance, removing or reducing the amount of alcohol you drink. You may also need to take more supplements beyond the basics, such as liver support and vein support, different types of B vitamins, etc. Supplements will not make you run faster (training does that), but it will help you in recovery and help you feel better after a long run or an exhaustive session.
And once again, please make sure to talk to your doctor first and get blood work done before taking anything!
To learn more about supplements and medical research behind their benefits check out the resources below:
Role of Zinc:
Vitamin B 12 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257642/
With the overwhelming amount of vitamins and supplements on the market, navigating those can be intimidating. We have put together a list of supplements that Elena shared with us (and added some of the ones we personally take). The list is not advertising, however it is compiled via Amazon affiliate link and if purchased may result in small comission earnings.
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