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  • Writer's pictureAnnie Bothma

Updated: Mar 11

In this second post, I dive deep into what really happened towards the end of 2023, why I didn't race Berlin Marathon and why I have been absent from the racing scene since then. I also share where I am now in my journey and the perspective I have gained from going through these major health and injury setbacks over this past year.

Disclaimer: I will be going into detail about my chronic health struggles and injuries, but I also speak openly about my mental health. I am not giving advice or guidance in this post with the hopes it will make someone else feel less alone in their own struggles with mental health. This is my personal experience; it is best to seek professional help/support.


I started August on a strong note with one of my fastest 40 km long runs yet. It was a regular Tuesday morning, but I was fueled by my goals and had work to do! With sights on the Berlin marathon, I was fired up and motivated. On a solo mission in my neighbourhood, I clocked a 2:27 for the 40 km.

Four days after that long run, I planned to squeeze in a short workout before racing the Totalsports Ladies Race the next week. But, during the first rep of this straightforward 8 x 1 km session, I felt one of the weirdest sensations ever. My whole body went numb. It felt like my heart was beating out of my chest, and my head was going to explode. I collapsed on the sidewalk shortly after hitting the 1 km mark. I was completely out of it. What happened?!

I could hardly jog during the following few days, but I still boarded the plane in hope of racing in Durban on the 9th of August.

Needless to say, I endured the race and clocked my slowest 10 km time since my junior years. It was even slower than the 10 km splits of my most recent marathon, and most of my long runs. Throughout the race, I grappled with symptoms like dizziness, fatigue, fogginess, headaches, and skyrocketing heart rates.

After returning home, I did some testing to find out what was going on. An ECG revealed abnormal spikes in my heart rhythm, potentially signalling an electrolyte imbalance. The next day, it was confirmed by blood tests: I was severely dehydrated and had clinically low sodium levels, indicating Hyponatremia*. The results were severe enough to put me at risk of a seizure, like I experienced in 2022.

I try my best to manage my Diabetes Insipidus**, but when you lose litres of fluid every day it is hard to keep up. I take salt pills daily to offset the sodium losses from my prescribed medication. Instead of plain water, I opt for electrolytes. I am constantly trying to learn more about this condition and how to manage it. However, chronic illness can be relentless: it doesn't care about your goals. There's no easy fix or cure. It's something I'll have to manage for the rest of my life.

*Hyponatremia is a medical condition characterised by a low concentration of sodium in the blood. Sodium is an essential electrolyte that helps regulate water balance in and around cells. Hyponatremia occurs when the sodium level in the blood falls below 135 millimoles per litre (mmol/L). This imbalance can be due to various factors, such as excessive water intake, certain medical conditions, or medications. Symptoms of hyponatremia can range from mild to severe and may include nausea, headache, confusion, fatigue, and, in severe cases, seizures or a coma. It's a condition that requires careful medical management to correct the sodium imbalance safely.

**Diabetes insipidus is a rare condition characterised by intense thirst and the excretion of large amounts of urine. It occurs when the body cannot properly balance fluids. This imbalance is typically due to a malfunction in the production, storage, or release of antidiuretic hormone (ADH), also known as vasopressin, which is produced in the hypothalamus and stored in the pituitary gland. ADH regulates water balance in the body. There are two main types of diabetes insipidus: Central Diabetes Insipidus: Caused by damage to the hypothalamus or pituitary gland, affecting ADH production, storage, or release. Nephrogenic Diabetes Insipidus: Occurs when the kidneys don't respond properly to ADH.

Symptoms include excessive thirst and urination, which can disrupt sleep and daily activities. Treatment depends on the type and involves either replacing ADH (for central diabetes insipidus) or taking medications that reduce urine output (for nephrogenic diabetes insipidus).


I think the reason this part took me so long to write was due to the fact that I didn’t understand what was happening in my body. Pain is a clear indicator that something is wrong, but I didn’t have pain. My symptoms were unlike anything I have experienced before.

The first signs of weakness came shortly after I ran the Total Sports Ladies Race. I started experiencing weird sensations. I was losing power and feeling in my left leg. At first, it was subtle. It only happened on certain days, but it gradually became a daily struggle.

I intitially thought it was something I needed to fix. In my stubborn endurance mindset, I told myself to just work harder. I went to see a biokineticist, who gave me a couple of plyometrics and strength exercises to correct the supposed power imbalance. I worked hard in the gym, but that only made it worse.

My symptoms progressed to a point where I could no longer execute speed workouts or finish long runs. I felt like my left leg would collapse underneath me – my whole foot would go numb and would tingle with pins and needles.

Ultimately, that was the primary factor in my decision to pull out of the Berlin Marathon. You can't show up on race day if you didn't do the work. Confidence comes from knowing you've prepared well for the task ahead.

I was not prepared.

I couldn't run my race pace without feeling like I was hobbling on one leg. I didn’t know if I would be able to finish the race anymore. It was one of the hardest decisions I've ever made, but I knew it was the right one.

Pulling out of the Berlin Marathon was so painful. It was my first opportunity to run in a major overseas marathon amongst the best athletes, like world record holder Elliud Kipchoge. It is one of the biggest, most prestigious races in the world – and flat as a pancake. Most of the South African races are too hilly to run times comparable to fast marathons like Berlin and Valencia.

I had this big opportunity standing in front of me, and I couldn't seize it.


On the weekend of the Berlin Marathon, a storm woke us during the night. Gusts rattled the windows and doors. On the morning of the race, I went for an easy run in one of the craziest wind storms I have ever experienced.

There was damage everywhere: scattered leaves, trees blown over, and even garbage bins lying around. It was one of the worst runs of my life. I felt like I had no power in my left leg.

My diabetes insipidus was rearing its head, leading to an onset of neuropathy: the cold caused constant swelling in my hands and feet. It was torture. I was chronically dehydrated, which led to relentless fatigue and headaches.

My hands and feet were constantly swollen and very painful as a result of my diabetic neuropathy

Running no longer felt natural and effortless like before; it felt forced and uncomfortable – the fun was gone.

Conditions worsened the next day, and we had some of the heaviest rain of that winter. The river overflowed, which added to the already severe flooding and damage to the town.

Between my symptoms, this injury, and just trying to survive, the storm felt eerily symbolic of my life.


The reason why sharing this whole experience took so long was that I found myself in one of the darkest places I have ever been… and I have been to some pretty dark places. This time I was in so deep, I didn’t really have the energy or courage to share it with anyone.

Who would want to hear something this depressing? I didn’t want people to feel sorry for me. I wanted people to just forget about me.

I wished I could just disappear.

In fact, for a couple of months not a day went by without overwhelming thoughts of self harm. The burden became too heavy. Not only was I suffering through severe daily symptoms, my largest source of joy and meaning suddenly made me feel weak!

I was also under immense financial pressure. I lost my major sponsorship at the end of 2021, during the pandemic. I really hoped that claiming the national title by winning the Durban International Marathon would lead to another sponsorship. The feedback I received after the race was that it was not good enough for sponsors or elite clubs. My 2:30:00 effort was too slow. It fell short of both the Olympic qualifying mark of 2:26:50 and the World Standard of 2:28:00.

‘Simply work harder,’ I told myself, setting my sights on the Berlin Marathon. But, when that too slipped away, I became desperate. And being desperate often leads to poor decisions.

After withdrawing from Berlin, we tried to find a new marathon that would have given me more time, which led to acceptance into the elite field of the Abu Dhabi marathon in December.

I should have just taken a step back, allowing my body to reset. Yet, I pressed on, striving to lift some of the financial pressure I was placing on my parents, due to extreme medical costs.

I didn't have pain, therefore. not running at all felt unjustifiable, but it was incredibly uncomfortable. There were pins and needles running through my left leg, which would lead to a complete loss of feeling towards the end of a run.


Barely afloat and we're taking on water

Still chasing the high that I felt the whole summer

Being buried alive with a smile on my face

A drink in my hand and a day to erase

I'm picking up the pieces, please just look the other way

I'm picking up the pieces, please just look the other way

I go off the rails every chance that I'm given

Is it worth my life if it means I might fit in?

I look at the wounds that I choose to inflict

While I hold my tongue and I tighten my grip

I'm picking up the pieces, please just look the other way

I'm picking up the pieces, please just look the other way

I'm not falling asleep, wish my heart would beat slower

Thinking back on my year, wanna start it all over

I wake you up and I tell you I'm losing control

I'm barely surviving, but I need you to know

I'm picking up the pieces, please just look the other way

I'm picking up the pieces, please just look the other way

'Cause baby I'm afraid I'm slowly pushing you away

By showing you the deepest, darkest, weakest part of me

You said you'll always be right here to keep me company

When I don't even love myself you love me anyway

When I don't even love myself you love me anyway

~ Look The Other Way, By Baretooth

While cross-training on my ElliptiGo, I listened to this song by Baretooth. The lyrics really spoke to me at the time. I longed for a reset button for this year – something to undo the mistakes I made, to prevent this all from happening.

But, even if I could have gone back, I was still puzzled. What were those strange symptoms I felt during runs? How did I suddenly become so weak? What happened to the marathoner I used to be?

The one thing I did know was that I had reached my breaking point – both physically and mentally.

I needed to start picking up all the broken pieces… even though they seemed beyond repair.

We finally decided to get testing done. The pain wasn’t unbearable, but I knew the experience was not normal. An MRI showed an annular tear in my back, in the exact same location that got hurt during a car accident in America. My spine looked healthy when we compared the scans to the ones done in 2018, but the disc between L5 and S1 was badly compromised. This time, there was a significant tear in the disc, which explained the severe nerve irritation that was radiating down my entire left leg.

The doctor deduced the cause to have either been falling or lifting something heavy. It could have been the fall in August or a gym session, or something else entirely. I honestly don’t know, but playing the “what if” game never helps.


Ultimately, I knew I had to let go of trying to race another marathon in 2023, and had to focus on getting my injury sorted. I underwent two medical procedures of which the first did not bring any relief in symptoms.

I was at a point where I couldn’t even drive anymore! In fact, simply sitting caused a loss of feeling in my leg and extreme pain in my left upper-hamstring glute insertion. I depended on my parents to drive me to appointments for the entirety of December, which included a physio who specialises in nerve pain and back injuries.

Embrace the Suck = The ability to gut out the tough times; to find happiness and even fulfilment during difficult times – an indispensable skill and mindset.

Once the festive season rolled around and my family went on holiday, I decided to stay home alone with my pup, Nike. The thought of sitting for long hours in a car sounded painful. It gave me the chance to reflect on the year that had passed.

I needed to bide my time, allowing the story to unfold.

I spent hours strolling in the beautiful vineyards and mountains with Nike, listening to my favourite podcasts. How I dreamt of running up those hills instead – and flying down on the other side.

I also did a lot of journaling, focusing on writing down my core values and coming back to my WHY. I had to admit, to myself, that I was no longer living as my authentic self, and not showing up in the world the way I aspire to.

I am not a victim of my illness or this injury! I have learned to embrace the suck.

While I could not run, I poured my energy into my coaching and nutrition business, Annie’s Athletes. At least I could help others achieve their goals and dreams. I could support and guide them through their training journey, as well as teach them good nutritional habits that will not only lead to their best performance, but also give them longevity in the sport that we love so much.


On the first of January, I ran on the grass for 20 minutes and finally felt the ground underneath both my feet for the first time in almost 6 months! I gradually increased my distance such that I was ready to start transitioning back into marathon training by the end of January.

I started making great progress and was preparing to defend my title of South African Marathon Champion at the Durban International Marathon, but then, on the 12th of February, during my first long run in months, all my symptoms came flooding back. I was only 3 km into the run when I started losing feeling in my left leg and feeling pins and needles in my foot. By the 10 km mark I was basically running on one leg and was forced to stop and walk back home.

You make progress in drops, and you lose it in buckets.

My dream was over. It was time to let go.

In 2015, when that car hit me in America, my whole life changed.


This is the most serious injury I have experienced in my running career, and what makes it so hard is that it wasn’t even caused by running. No amount of rehab or strength work can fix it.

There is nothing I can change in my diet to help me heal faster. It was an accident that injured my back, and only time will tell if I will be able to overcome it.

Right now, I can only walk and do some strength training. I don’t know how the journey back will look…

BUT, I do know that I am not ready to give up just yet!

Is this possibly a career ending injury? Have I considered retiring and stepping away from the sport?


Honestly, sometimes I wish I cared less and didn’t love it so much.

It’s a part of me. I really can’t imagine my life without it. I also know I have more to give. I do not believe I have tapped into my full potential. I have not achieved the goals I set for myself. In practice sessions, I have seen glimpses of the times I think I am capable of, but it means nothing until I clock them in an official race.

I have unfinished business.

I may not have a lot to show for 2023, or 2022 for that matter. In fact, since 2020, it has been a wild ride, both personally and professionally. However, I have gained so much knowledge about my own body, my medical conditions, nutrition, and training. I believe it will set me up to make better decisions moving forward; decisions which will not only benefit my health, but also my athletic performance.

“I’ll never be as great as I WANT to be. But, I am willing to spend my entire life trying to be as great as I CAN be.” — Kenny Aaronoff

If you’ve made it this far…


Thank you for taking the time to read my story and following my journey. It really means a lot to me.

I do hope this post helps someone out there who may also be struggling with some dark demons or battling through an injury, illness, or some other setback. Know that you are not alone in your fight.

~ Written by Annie Bothma, edited by Francois Bothma

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  • Writer's pictureAnnie Bothma

Here we go…

It took me a while to gather the courage to write this. I often wanted to share, but I simply couldn’t. I didn’t know what was going on in my own body. I feel like I have lost the ability to move organically and run freely.

To me, running feels natural. It is like breathing – without it, I almost feel suffocated. A day without a run feels weird, like something is missing. It has been my biggest passion for as long as I can remember. It spread through every aspect of my life: the people I surround myself with, the content I consume (like podcasts, books, online articles, and newsletters), as well as my day job of being a running coach and sports nutritionist.

However, for the past few months, running no longer felt effortless. I had to think of every step – every run became a grind. It was mentally exhausting.

That’s when I knew I had to stop.


Why did I disappear from the racing scene after being crowned the ASA marathon champion at the Durban International Marathon in March, 2023? Hopefully I can shed some light on what happened.

I hope sharing my journey will help others avoid similar challenges by being proactive, thus avoiding the months of struggling I had to endure. Furthermore, I hope to make others who also had a year rife with illness or injury feel less alone.

Lastly, I hope that this inspires or motivates you to keep fighting, even when it feels like the ground is shifting beneath your feet.


I wrote a detailed blog post, The Comeback Code, on how I made the transition back into racing after my pandemic-induced hiatus in 2020/2021. It also discusses a series of bone stress injuries I suffered, due to an incorrect medication dosage in 2022. I will not repeat the details here.

I concluded by saying that I stopped trying to qualify for the 2023 World Championship Marathon, deciding to rather chase the Olympic standard of sub-2:28:00 before the qualifying window closed. However, things didn’t go according to plan.

In fact, nothing went according to plan in 2023.

After the Durban Marathon, I made a meticulous race schedule, with target races and goals assigned to each month. I was ecstatic to finally compete again – it felt like a fresh start.

I was invited to compete in the elite field of the Geneva Marathon, which took place on the 7th of May, 2023. I spent two weeks training at lower intensity after winning the Durban Marathon.

Then, in April, I had some of the best training ever, once I got back into structured workouts and long runs. I broke a few personal records, both in workout times and weekly mileage. I completed a 30 km long run with an average of 3:33/km, verifying that my endurance was still there. It also felt like my speed was coming back, for the first time since 2021, when I did one of my fastest 5 km tempo runs: 15:03.

However, we soon realised that I was training for the wrong race. Looking at forecasts and historical weather patterns for Geneva, a Swiss city that lies on the southern tip of expansive Lac Léman (Lake Geneva), we saw that typical temperatures were around 4-7 ℃ around the marathon’s date. The city sounded idyllic, surrounded by the Alps, the Jura mountains, and views of dramatic Mont Blanc, but acknowledging that cold is one of my biggest weaknesses, I knew that, at best, my performance would have been subpar, but, at worst, there was the risk of serious health complications.

As temperatures dropped in the Western Cape by the end of April, we knew declining the invitation turned out to be the right decision. My training gradually became inconsistent as my health deteriorated. My body no longer responded to training like it did during the warmer months, with the pace I hit leading into the Durban Marathon being reduced to a tantalising memory. In desperation, I shifted all my training to the middle of the day, when temperatures were a bit warmer.

I decided to stop trying to qualify for the Marathon World Champs in Budapest as I realised my time was going to run out. I started focusing on shorter distance races instead. My main targets were the ASA Half Marathon Championships in June, the prestigious ABSA 10 km series, and the ASA 10 km in November. The idea was for these smaller goals to set me up nicely for my main goal, which was to race a fast marathon in the second half of the year.

As you may know by now, all those races have passed and I wasn’t on the start-line at any of them!

So, what happened?!


In May, I was preparing for the ASA Half-Marathon Championships, which took place on the first weekend of June. However, two weeks before the race, I got Bronchitis. It was the first and only time, in 2023, that I got sick outside of my chronic illness. The timing could not have been worse.

I have been lucky when it comes to colds or flus. I never caught Covid-19 throughout the pandemic. We realised that it would not be wise to race a hard 21 km. Potentially extending, or worsening, this sickness was not a risk I was willing to take, especially with the danger of creating a long-term problem.

I looked forward to competing again, and representing Western Province Athletics, so it was frustrating. That said, I also acknowledge that it’s not just about me. I would have travelled as part of a team, so I could’ve infected those around me. I would have felt terrible if I had ruined a teammate or competitor’s race, potentially also costing them a few weeks of training afterwards.


I decided to put the disappointment behind me, and work towards the next goal.

The fire lit up again when I got invited to compete in the elite field of the Berlin Marathon. I went out for a long run in Cape Town that weekend, excited and motivated to prepare for joining the best in the world on the flat and fast streets of Berlin. This would’ve been my first time competing in an international marathon overseas, not to mention one of the prestigious Abbott Marathon Majors.

The weather didn’t share my excitement, nor care about my long run plans that day. It was already a cold morning. Then, what started as a drizzle turned into a pour half way through the run. I ended up next to the road, battling with hypothermia. The one moment I still felt strong, the next my vision started blurring and my legs became heavy. I started losing motor-control and could no longer keep a straight line. I was forced to start walking, until my body came to a grinding halt. My dad had to cycle as fast as he could back to the car to come pick me up, while a stranger waited with me as I shivered uncontrollably.

We had one of the worst winters ever in the Western Cape. It may not seem significant compared to some countries, but to us South Africans, who are used to pretty mild winters, it was certainly a shock to the system. We had the most rainfall in over 40 years, accompanied by flooding, icy temperatures and insane winds. There was a lot of damage, both in my neighbourhood and in surrounding areas.

Nonetheless, I wrote in big, bold letters on my blackboard: I WANT THIS MORE THAN ANYTHING ELSE. I WILL BE AN OLYMPIAN IN 2024.

I was determined not to let the weather stop me. I convinced myself that I'm stronger than the storm and should just push through. However, sticking to a structured schedule became increasingly challenging. While I managed to clock easy miles, executing quality workouts and long runs proved difficult as my body tended to shut down in the cold and wet conditions.


My marathon-specific training began 12 weeks before the race on September 24, 2023. To elevate my performance, my agent suggested collaborating with a coach, whose name I've decided to keep private.

Being self-coached is essential for managing my chronic health conditions effectively. Each morning, I check my vitals, follow my activation and warm-up routine, and make decisions based on my body's feedback: a few key markers indicate extreme dehydration or low blood pressure. I've learned not to push myself too hard in challenging conditions, like icy temperatures or heavy rain, to avoid setting myself up for failure.

With the desire to elevate my performance to the next level, I gave being coached a shot. Sometimes, advancing requires a different approach than what you've done before. It's great to have someone who genuinely cares about your progress provide feedback on training.

I quickly realised that his coaching approach didn’t support my progress. He proposed changes to elements that had previously proven effective for me, such as my weekly mileage, workout types, warm-up/cool-down routines, and strength training schedule. Staple components like hill repeats, fartleks, tempo runs, and post-easy run strides were entirely removed. His plan focused on just two key sessions weekly: a long interval track session, alongside a long run or extended run with marathon-paced intervals.

While this approach might suit some, it wasn't the right fit for me. Coming from a non-track background and lacking natural speed, I found shorter, faster workouts and power-based training like hills and resistance exercises in the gym crucial to maintaining my speed. The main issue revolved around his training philosophy. In the past, if I missed a session due to health or bad weather, I had no issue shifting it by a day or two. However, in his eyes, missing a session meant it was lost, and we had to move on with the program. I've found that I make progress when I listen to my body and adapt to its readiness, rather than forcing a response. Managing my medical conditions is a constant aspect of my life, both as an athlete and in my day-to-day.

He was inflexible and reluctant to adapt. Insisting on track intervals, he dismissed my preference for the road or grass. The last time I did consistent track training was in 2019, before my first marathon, during short weekly sessions with the Cape Town based ATC club. One evening before a workout, he called and instructed me to do four 3000m repeats the following day.

My aversion to the track wasn't without reason. Numerous hard falls throughout my life have left me with a few scars…

  • I've experienced eight concussions, starting when I was six years old.

  • If you glance at my knees, you'll notice dark stretch marks from numerous severe falls. Move a bit closer, and on my left calf, there's a deep, dark line. This scar is a result of a dog attack when I was thirteen; I lost half my leg and underwent 45 stitches and plastic surgery for repairs.

  • Despite healing, it has remained my weaker leg. I fell on my left side when a pick-up truck hit me in America while I was crossing the road after practice.

  • Additionally, my left side is slightly shorter than my right, which turns out to be pretty common.

Combining all these factors, my body doesn't not like repeatedly turning left.

When I shared this with him, however, his response was simply:

‘I'm sorry to hear that. Have a good session tomorrow. Send me the times.’"

Following that session, I encountered issues with my hamstring and hip. He obviously didn’t care about what my body requires for optimal performance, taking my chronic health into account. Moreover, he never took my training and injury history into consideration. When he told my agent not to worry about my health, attributing my fatigue to marathon training and high mileage, it was conclusive evidence that he wasn't the right coach for me.

Until then, I'd been injury-free for the year. Apart from the bone stress injuries caused by a medication dosage error the previous year, I'd been running without significant issues since early 2019. While all runners deal with occasional niggles or tightness, I hadn't faced anything that required a complete stop to my running routine. Unfortunately, in the following weeks, that reality changed, ultimately leading to taking a step back.

In my following blog post, I will elaborate on the most frustrating and challenging injury I have had in my running career, and where I am now in my recovery journey.

To be continued...

~ Written by Annie Bothma, edited by Francois Bothma

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  • Writer's pictureAnnie Bothma

The following post is a detailed description of my comeback to the road racing scene to win the Durban International City Marathon that took place on the 12th of March 2023 in a new course record of over 7-minutes, while simultaneously claiming the South African Marathon Title.




I made my marathon debut at the Sanlam Cape Town Marathon in 2019. I went into this race extremely under-trained and ill-prepared for the rigorous demands of the marathon. Racing the marathon requires an athlete to train at a much higher volume to be able to tolerate the pounding that comes over the 42.2 km (or 26.2 mile) distance. At the time I was only racing primarily 10km road races, as well as the odd 15km or 21km every once in a while. I had just returned from the USA, the previous year in the middle of 2018, where I only races 5/6km cross country races or 5 000m or 10 000m on the track. I never need to take in nutrition during the race.

When you race a marathon, fueling adequately before and during the race is a big part of what will allow you to achieve your best performance. In the months preceding the race, you have to train your gut to tolerate fuel during training, just like you train your muscles to tolerate the pounding from the road. Before my debut marathon I didn't understand the importance of fuelling and it lead to a terrible encounter with the dreaded marathon wall!

I planned to take in three gels during the marathon (which is not enough!!!) but I only got in one! The first gel, someone else took before I got to the elite table and the second one I opened up too quickly and it shot all over my body, except in my mouth! Eventually I got my first gel in at the 30km mark, but it was way too late, the damage had been done! I went from running a 2:35 marathon pace to finishing in a 2:41. This was the catalyst that drove me to start studying sport nutrition, so I could truly understand the metabolic demands that comes with racing the marathon.

However, I did manage to finish 10th overall and was the first South African to cross the finish-line that day. In 2019, the Cape Town Marathon also doubled as the South African National Marathon Championships, but due to the fact, that I was not selected to represent Western Province, I could not be awarded the national title. I had approached WPA before the race to run in their colors, but they rejected me. I understand, it was my debut and they did not believe I could finish a marathon.


I went to Kenya at the end of 2019, to train for the Vienna City Marathon in May 2020, however, when the whole world shut down in March of 2020, I quickly had to return to South Africa to go into lock-down.

During the pandemic, I completed 7 marathon build-ups without racing the marathon at the end, due to all the race cancellations and postponements that was going on at the time. It was truly a sad time for the running community and I know I am not the only athlete who didn't have any opportunities to compete.

However, I kept training and kept hope that my opportunity would come to race again. It never did. But through the pandemic I ran solo-time trials instead of races to challenge myself and improved my personal best times from the 5km up to the marathon.

One of these were an actual event that took place in October 2020 instead of the mass-participation Sanlam Cape Town Marathon. The race organized an Elite Marathon on a looped course in Cape Town. It was a very lonely and mentally challenging race. I ran solo without a pacer or bike to help me for the entire duration of the race in 4-5km loops, with the majority of it being cobble stones. I wasn't properly tapered for the race either, since I was busy preparing for a marathon at the end of that year (that ended up getting cancelled as well!)

However, it was still an opportunity that I was grateful for, since I got to run at an event with official timing and that would be more than just another Garmin file on my watch. I managed to win and still run a time of 2:33:35 on the day.


In September 2021, I was diagnosed with Central Diabetes Insipidus (CDI). This condition occurs when the body can't regulate how it handles fluids. The condition is caused by a hormonal abnormality, in my case, it is directly linked to my hypopituitarism and my body’s insufficient production of antidiuretic hormone (ADH). CDI is not related to type 1 or type 2 diabetes (also known as diabetes mellitus), but it does share some of the same signs and symptoms. The two main symptoms of CDI are extreme thirst (polydipsia) and frequent urination.

Before I got diagnosed and received treatment, I was chronically dehydrated and, as a result, my athletic performance suffered. The main reasons why dehydration has adverse effects on exercise performance are: reduction in blood volume, decreased skin blood flow, decreased sweat rate, decreased heat dissipation, increased core temperature, and an increased rate of muscle glycogen use. My blood pressure would drop and I would end up being dizzy and disorientated. I battled with the cold and often lost feeling in my hands and feet. I frequently fainted, during both training and races.

To manage my condition, I was prescribed a synthetic hormone called desmopressin acetate (DDAVP). This medication replaces the missing ADH, which is supposed to be secreted by my pituitary gland. Gradually my medication was increased with the goal to counteract the amount of fluids I was losing through urine, but it was now more concentrated than before. I was losing a lot of electrolytes, especially sodium.

We had trouble figuring out the correct medication dose for my body to manage this condition and as a result a whole host of medical complications occurred that side-lined me from competition form the end of 2021 until December 2022 when I raced at the ASA Cross Country Trials in Potchefstroom.



I only started running at the beginning of November 2022, after taking 5-month complete break from running and doing very little running in the months preceding during the first half of 2022. Therefore, when I initially started running I didn't think I would be able to run a marathon in 2023. I wanted to try to make the team for world cross country and represent my country in Australia.

I went into the trials very under-trained. My body felt so sore afterwards, that I could only do easy shorter runs for a whole week. To be honest, my body actually feels better now, after running a marathon than what it did after that 10km at the ASA cross country trials back in December! It was to be excepted that I would struggle, since I was only able to cover the 10km distance for the first time 2-weeks before the trials. I also only managed to do one 30-minute fartlek workout before the race, which was definitely not enough to compete against the strong field that lined-up on the day.

However, after placing 4th at the trials on 3 December 2022, I finally felt like I got a bit of trust and confidence back in my body and started believing again that just maybe I would be able to run a marathon the next year. I knew I was basically starting from scratch. I had to build a base again, before I could consider doing any hard workouts or attempt marathon distance long runs.

On Monday the 12th of December, I started following a structured running program again. For the first time in a very long time, I was no longer just doing easy runs, but structured workouts and a long run weekly. In December 2022 and January 2023, all my training was geared towards handling the challenges of a cross country course. I did A LOT of hill repetitions and fartlek workouts on the grass or in the mountains. The only exception was the long run, which I gradually increased as my body got use to the pounding of the road again.

Representing South Africa at the IAAF World Cross Country in Poland as a Junior in 2013 and in China as a senior in 2015, was one of my career highlights. Therefore, I was fully focused on getting fit as possible to be ready to represent my country on the 18th of February in Australia to the best of my ability.

However, when the final team was announced on 3 February 2023, my name was not on the list. The criteria that was sent out before the trials stated, that the top 5 across the line at trials would go to Worlds and that there would be one discretionary spot. Why, was I not selected you may ask...I can't give you a clear answer, because I don't know either.

I followed the path I thought you were suppose to follow if you wanted to make the team. I took a big risk not being fully ready to race. I made a big financial investment paying my own way to go run at the trials. But, I knew that team was final. The only thing I could do was accept it an shift my focus towards a new goal...

The ASA Marathon Championships


On the 4th of February, I ran and finished my first road race since the end of 2019. I raced the hilly Firgrove 15km challenge where I managed to be the first female athlete across the finish-line. The following day, I went out on tired legs and ran a 30km long run. I was all in now on racing the Durban International Marathon in six weeks time on the 12th of March 2023.

Throughout the rest of February, my workouts changed from hill repetitions, fartleks and short 400m repetitions on the grass to long speed-endurance marathon style workouts. One of my favorite workouts that I did two times during that month was: 4km (1km float) x 4 for a total of 20km. The second time, I managed to improve my times, which showed me there was progress in my fitness.

I did another race as part of training. On the 19th of February, I raced the Cape Peninsula Half Marathon on a particularly windy day. I battled running 21km straight into a very strong headwind on this point-to-point course. I was very lucky to still win, but felt pretty defeated running a slow time, even slower than my training times or target marathon pace. But, in hindsight looking back at it now, I think it helped prepare me mentally for the windy weather conditions that I had to face on race day at the Durban Marathon.

Three days after I ran the half marathon, I did a 35km as my last long run, before the marathon. The goal was to run progressive and try to finish strong. I felt strong and the pace felt comfortable from the start, which allowed me to run faster than my target. This gave me hope that I was finally getting closer to the fitness level I was able to achieve back at the start of 2021, before I took a break from running. I also used this opportunity to practice my fuelling and grabbing bottles from a table for one more time.

Very important to note, I did NO double runs on the road during the three months before I ran the marathon. If I did a second session it was always cross training on the ElliptiGo. I also continued to do some sort of strength or core work in the gym every single day to strengthen my body and help prevent injuries.

I also didn't run close to the mileage I use to in the past, when I was preparing for marathons during the pandemic, simply because my number one goal was to make it to the start line healthy and injury free. I knew, I needed to be very careful and conservative coming back from such a long break from running. However, this does kinda makes me excited, because I know there is more room for growth and improvement in the future.


I went into this race with a very positive mindset and had all intent to go out hard and fast! I wanted to see what my body can do after such a long time not running the marathon. A big goal was also to really RACE the marathon for the first time. This first time around it was just so daunting finishing the 42.2km, and the second one it was more a race against the clock! This time, I wanted to race to win!


However, warming up in the rain with the wind raging around me, I must admit I was pretty worried. Due to my medical condition, my body does not tolerate cold temperatures very well and I have had many failed workouts, long runs and even races as a result of my blood pressure and core temperature dropping too low. Luckily, due to the fact that the humidity was so high, at around 85%, it wasn't that cold and I managed to get through the race without experiencing any of these symptoms. I only lost feeling in my hands.

The biggest factor ended up being the wind. It was extremely gusty out there, I don’t think the broadcast showed just how bad the wind really was out there. Due to the fact that it rained before and during a big portion of the race made the footing pretty bad. There was a lot of big water puddles on the roads that we had to dodge and the promenade was very slippery, making it hard to run fast.

I knew, we all had to face those conditions, so I tried my best to focus on my form and stay positive. However, it definitely impacted my ability to run fast and achieve my goal time.


The most frustrating thing on the day was the shortage of refreshments along the route. After my nutrition failure during my first marathon, I didn't want to make the same mistake twice. I also have the knowledge now, after completing my masters in sport nutrition, to fully understand what difference it can make in your performance to fuel and hydrate adequately during a marathon.

I planned to get a bottle every five kilometers, but they told us at the pre-race technical meeting that there would be no bottles at 5km and 15 km. The refreshment tables were also not where they were supposed to be. My first bottle was not even at the 10K station, I only got the first at 12 km mark and although I was still on pace at the time, I could feel that the damage had already been done. The most important fuelling stations are during the first half of the marathon, since as the duration and intensity increases as time passes, it becomes harder and harder for the body to absorb and digest nutrients and use it for energy. This is because blood-flow gets shunted aways from the gut to the working muscles who needs it more at that stage.

I think that’s definitely something this race can improve upon. I don’t understand why it’s so hard to put a table every five kilometers for elite runners. You’re already focusing so hard for two-and-a-half hours on that pace and you don’t really want to think about bottles that much. You just want to grab and go. Having low muscle glycogen impeded my ability to finish strong in those last 12km, like I did in my long runs and workouts. I was also very dehydrated afterwards when I was doing drug testing.


  • Remember, this was my individualized plan, I am not suggesting you copy this plan, I am purely sharing what I did.


  • 2.5 hours before the 6am race start


  • 1 bottle ISO ACTIVE Powerbar Drink


  • 75g of carbs/hour

  • 600 ml/hour

  • 7 x bottles of Powerbar - Alternating between Powerbar ISO-ACTIVE & ISO-MAX

Just an important note here: The reason I only use drinks, instead of gels and water is because one of my biggest risk factors during exercise is dehydration with my Diabetes Insipidus. I am always a bit dehydrated just simply because of the amount of fluid I lose through my urine daily. I also wake up multiple times during the night to go to the toilet, and as a result, I already start my day in a deficit. Therefore, I need to make sure I prioritize my hydration during the marathon, especially if it is hot or humid. You may find using a combination of gels and drinks/water work better for you.

This is also why Powerbar has been an absolute game-changer in my performance and health! Water just runs straight through me, while Powerbar ISO-ACTIVE & ISO-MAX drinks and their electrolyte tablets contains added sodium that helps retain fluid better. It also contains calcium, magnesium, chloride, and potassium that is lost in small amounts through our sweat.

I had zero gastrointestinal (GI) upset while using Powerbar products on Sunday. In fact, I have never had any GI upset using their products, which is huge for someone suffering from Celiac Disease! At least, I know I have a good product that works well for me in Powerbar and I do hope that in the next opportunity I get to race the marathon I will be able to execute my race day nutrition plan better!


At the 39 km, when the former winner of the Two Oceans Marathon and Soweto Maraton, Chaltu Bedo Negashu from Ethiopia, tried to pass me, I told myself:


I had worked too hard and come too far to let her pass! I dug really deep, and immediately accelerated, opening a 10m gap. I kept pushing for the next 3.2km until the finish-line. The victory of finally breaking that tape was truly a combination of so many months and years of struggle and suffering that finally paid off!

I managed to break the course record by last year's winner, Shelmith Nyawira Muriuki from Kenya (who was third in the race this year), by more than seven minutes. I also improved my personal best time of 2:33:35, that I ran in the Elite Sanlam Cape Town Marathon in 2020, to 2:30:31. The defending ASA Marathon champion, Jenet Mbhele, was 4th overall and the second South African home, also in a new personal best time of 2:37:08.


I am not 100% sure yet, since one opportunity opens up another door for you and I would like to be in the position where I can say yes to good opportunities that may come across my path. I have missed out on so many great opportunities due to my health struggles and all of the setbacks I have faced in my life, that right now, I am at a stage in my life where I am living day by day. I really appreciate every day I am healthy enough to put on my shoes and go for a run. I can and will never take it for granted: I run with an attitude of pure gratitude!

However, because I did not achieve the time goal I set for myself going into the Durban international Marathon, I have decided to give myself another shot to try run the World Championship Qualifying Standard of Sub-2:28:00, before the qualifying window closes on 31 May 2023.

It will be a short turn-around and is certainly not ideal, but I believe that if I can perhaps eliminate some of the external factors that went wrong in Durban, I may just be able to still make my dream a reality!

Stay tuned, more detail coming soon!

Thank you for reading and following along with my journey. I appreciate your support and hope that my story can inspire you to also chase your dreams, regardless the obstacles that may come across your path. #runtoovercome

~ Annie

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