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As a little girl, I had this quote, by Nike, written against my wall, "All your life you are told the things you cannot do. All your life they will say you're not good enough or strong enough or talented enough; they will say you're the wrong height or the wrong weight or the wrong type to play this or be this or achieve this. THEY WILL TELL YOU NO, thousand times no until all the no's become meaningless. All your life they will tell you no, quite firmly and very quickly. AND YOU WILL TELL THEM YES!!"

My anthology of ailments started at the innocent age of six, when I was diagnosed with scarlet fever, and had to be hospitalised. When my fever went above 43 °C, I was rushed to the ICU, where I spent an excruciating week. My family sat waiting in horror as the doctors told them that large amounts of Streptococcus bacteria burst inside my bloodstream, leaving my body in a toxic state. Fortunately, the doctors managed to save me from the brink of death, but something else within me died. I went from being a happy child, skipping and running everywhere I went, to the sickly little girl who was frequently absent from school.

​I stopped growing at the age of eleven. During the following years we saw a multitude of doctors, each failing to tell me the cause of my strange condition. At the age of seventeen, in 2013, I was diagnosed with Celiac disease, which triggers an allergic reaction upon the digestion of gluten. The consequence of this truth was, however, not as positive as I had expected. My health declined even further over the two years that followed the news. Symptoms included fatigue, weight loss, inability to handle cold, anaemia (low iron), low blood pressure, and dizziness, just to name a few.​

The answer finally came through a diagnosis done by an endocrinologist in June, 2015. He told me that I have a rare disorder called Hypopituitarism, which causes the pituitary gland, situated at the base of the brain, to fail in its production of hormones by producing too little or, in rare cases, none. Doctors suspect that the extreme shock my body went through when I had scarlet fever as a child might be the root cause, but it is impossible to reach a certain answer. The hormones secreted by this bean-shaped gland influence nearly every part of the human body, including growth, reproduction, and blood pressure. The absence of these critically important hormones can thus cripple the development of the human body, which was undoubtedly apparent in my case, since I am severely undersized when compared to my family, in both weight and length, and I lack some basic development usually undergone by a growing child. The explanation behind my still reasonable length lies in my genes. Despite the struggles with my health, I began to excel at distance running. By the age of 19, I already represented my country twice at the world cross country championships, won two SA Junior gold medals, and held provincial records. I was then fortunate enough to receive multiple scholarship offers to go run in the States and realized that it would have been foolish to let such a big opportunity slip.
I didn't have a soft landing in America, however. A month after my arrival, I was hit by a pickup truck from behind, while returning from practice. I still had the right-of-way, but the truck did not stop... I do not remember much of the incident - the ambulance came, and the rest is a blur. I suffered another concussion, tore my meniscus, got bone bruising on my knees, and hurt my back. It took me two months before I could walk without pain, and another ten months before I could compete again. I had no support and was alone in a foreign country.

I had to sit out on a redshirt (unable to compete due to medical reasons) my whole first year at the university and my illness wasn't responding as desired to the new medication. By the end of the school year, I was medically disqualified and forced to make the decision between going home, and forgetting about my running goals in the States, or trying to transfer, and hoping another University would give me a chance.

I refused to give up and transferred to a different university, where I was given the chance to compete again for the first time in a year. I finally started to see results after one year of treatment on my new medication. The symptoms presently appear less frequently, except for a few times when my medication had to be changed and my body had to re-adjust to the modification. I was thankful and excited that another university was willing to take a chance with me. I was determined to succeed and prove them wrong - I was going to overcome my illness and injuries. I did. At the second University, I competed for three seasons and was able to win 4 Conference titles (2 x Indoor 5000 m, 5 km Cross Country and 10000 m Outdoor track). I also won two NCAA Regional titles in the 10000 m and 6 km Cross Country. I ran in the 10000 m at the NCAA National Championships at Eugene in 2017 where I became an All-American (National Top 20).

However, I still struggled with my back and couldn't manage to run for more than three consecutive months without stopping again. I realized that if I wanted to continue running I would have to strengthen my whole body, and not just focus on my weekly mileage. I started with resistance training and focused on strengthening my weak core and glute muscles. I was studying Exercise Science and became increasingly passionate about fitness. I received both my Personal Training and Fitness Nutrition Certifications through ISSA (International Sports Science Association). I decided to continue my education and enrolled in the ISSA Master program, wherein I completed another four certifications to obtain my Master Personal Training qualification. These include qualifications in Group Fitness, Corrective Exercise, Youth Fitness, and Senior Fitness.

Sadly, I went through yet another car accident at the beginning of 2018. This time my car rolled after being hit from the side. Physically I escaped with minor injuries - only a concussion and whiplash - but mentally it broke me. I totaled my car and had a lot of financial stress to deal with. I had enough, and knew it was time to come home. I know my country is far from perfect, and I often get asked why I came back, but here I am surrounded by my people - the ones that love me most.

I started increasing my mileage at the end of 2018 and was rewarded with a personal best in the half marathon and 15 km. However, spinal injury recurrence stunted my progress, and I had to receive another cortisone shot with the hopes of competing in the 30 km Bay to Bay race. Unfortunately, I had to stop 18 km in, after losing feeling on one side of my body. It was a traumatising experience that prevented me from running for two months. I had to resort to pool training, and I focused on strengthening weak muscles in the hope that my body would be able to handle the impact again. My return included a slow 15 km race, but I was glad to be on the road again. Looking forward, my goal was the Two Oceans half marathon, but, once again, misfortune struck. The race started in darkness, and I slipped on a water sachet while going downhill. That incident left me desolate, as could be seen from my subsequent race performances. I didn’t feel the same desire and fire to compete anymore. I knew I had to find my spark again by taking on a completely new challenge. 

Clarity came in the middle of that year when I decided to do a longer run than I had ever done before. I completed 30 km in one hour, 57 minutes and felt ecstatic afterwards. I decided to attempt marathon training, and started building towards the Cape Town City Marathon, which took place in September that year. Looking back, I now realise how oblivious I was about how to properly prepare for a marathon. My mileage, although increased, still resembled the training for shorter distances. I am embarrassed to admit that my longest track workout before the race was a simple eight times 1km repeat. I received loads of conflicting information, and was left confused about how to approach my training. However, I built up to a 36K long run which I thought was enough to carry me the 42.2K distance on the day! 

I ended up being healthy enough to compete, but the race did not go as planned. Someone took my first gel sachet, and I spilled the second one, which means I only started fuelling after 30km when I was already glycogen and electrolyte depleted, as well as dehydrated. I realised what hitting the proverbial ‘marathon wall’ meant - the last 12 km was a death march. Despite these difficulties, I still managed to finish as the first South African woman with the 6th fastest debut in that category. Crossing that finish line was probably the biggest sense of achievement I’ve ever felt in my life, crushing the doubts people, including myself, had. 

I decided to throw everything I had at this newfound passion for the marathon. At the end of that year, I travelled to Kipsiat in Kenya, 3000 m above sea level, to train with the kings and queens of the marathon. I had the privilege of sharing a camp, and coach Erick Kimaiyo, with Brigid Kosgei, the current world record holder in the marathon. Being used to training at sea level, the transition came as quite a shock, having to endure routes of seemingly endless hills while feeling like you’re breathing through a straw. But, somehow, I managed. During my second week there I eclipsed my previous highest mileage week by about 20 km and did a 41 km long run. Living in a small rural township in a very basic camp with the bare basic facilities was also sometimes to get used to. From washing all clothes by hand, often being without water or electricity and cooking food on only a small gas stove or fire.  The nearest big town, Eldoret, was a 3-hour drive away and we're only able to make a trip every couple of weeks for some non-perishable items that I could take back to camp. The rest of my groceries all came from the local market on Sundays or when we made a trip to a small nearby township, Kachibora, which had a market with fresh fruits and vegetables as well as a very small supermarket. I felt strong until I got a viral infection that intervened at the beginning of 2020, which cost me about two weeks of training.  

I returned to South Africa shortly after to compete in a shorter race, but again my health wouldn’t allow me to finish. I had to spend a week in the hospital, as it turned out that food poisoning followed the illness from a few weeks before and threw my body into disarray. I did everything in my power to prepare myself for another trip to Kenya, for the same reason that I initially attempted altitude training: I was selected to run in the elite field of the Vienna City Marathon that would have taken place in April 2020. I flew right at the end of February but had to return after only a week due to the ominous rise of the COVID-19 pandemic.  

The uncertainty that we all had to deal with was tough. I started training hard, by increasing my mileage and doing strenuous workouts and tempo runs, with the hopes that I will be ready for the first race that came my way, but the months went by with nothing in sight. It was a difficult couple of years. Training was a lonely endeavour, and I ran multiple personal bests in training that could have won races. A small consolation came at the end of 2020 when I won the virtual Cape Town Marathon. It was, however, not an enjoyable experience, having to run all by myself in a looped course and struggling with a lingering stomach bug that made me feel nauseous for the majority of the race. The time was not nearly as fast as my fitness predicted, but I lowered my official personal best time, and I was happy with that. 
When restrictions finally loosened at the end of 2020 I returned to Kenya in November and was in the best shape of my life. I was ready to run a world-class marathon at the start of 2021, but the opportunity never came. I went through two more redundant marathon build-ups before finally getting a chance to race in Italy in April 2021. But, in what now seems a recurring theme in my running career, I got sick. This time it was the regular flu and I was unable to compete. 

After this my health continued to deteriorate. I collapsed during the South African Half Marathon Championships and had to withdraw from the race that could have qualified me for the 2021 Olympics in Tokyo and secure the spot I had on the potential Olympic squad. I decided to take a step back and take a more conservative longer build-up by shifting all my attention to the Cape Town Marathon in October at the end of 2021. I managed to, once again, improve my furthest long run distance, and ran some of my highest mileage weeks ever. My health was still a concern, so a lot of my training had to be effort based, but I felt confident. My long runs were faster than the previous year, so I knew the endurance was there. 

My symptoms got alarming in August, however, so I decided to seek expert help, which came in the form of Dr. Tim Noakes. He arrived at the conclusion that I had a rare disorder called Diabetes Insipidus. Shortly after that, the diagnosis was confirmed during a hospital visit, and I started with the appropriate medication. The weeks leading up to the race were anything but smooth. My body went into an erroneous inflammatory state, which led to injuries in my calves and wrist. I reacted by taking several rest days and a cortisone shot right before the race, but to no avail. The cold, rainy weather on the morning of the race embodied the experience. My warmup was agonising, but I hoped that the adrenaline and the magic of being in a real race again after two years would allow me to push through the pain. I needed to showcase my fitness and prove that my training achievements were real. When I stepped up to the start line, rain pouring down, I had to stand with confidence, but, inside, I was dying. The cold seeped into my shaking body, and the pain roared in my calf. After the gun, my body started shutting down, and dizziness enveloped me. I heard cries from the sidelines telling me to stop, and I knew they were right. I also heard my mother’s concerned voice saying that she can’t pick me up at the side of the road again, having to call an ambulance. She told me to stop before I collapsed. So that is what I did. I knew my race was over. The leaders were nowhere in sight, and just moving felt like an effort. The opportunity that I trained two years for slipped through my fingers. 

2021 and 2022 felt like a hazy fog of uncertainty. It felt like I could no longer trust my body. I got diagnosed with Central Diabetes Insipidus (CDI), and finally started receiving treatment for chronic symptoms, like dehydration and abnormally frequent urination, but the medicine has the significant side effect of causing hyponatremia, which I now know led to the four back-to-back bone stress injuries and seizure that I had to endure during 2022. I see the whole experience as a harsh, but valuable lesson on the importance of being a lifelong student – of both your own body and the world around you. Being side-lined from competition for more than a year also allowed me to obtain a Masters in Sport Nutrition, which equipped me with the knowledge needed to fuel my body for both peak performance and longevity in the sport. 


After making the necessary adjustments to my medication, I was able to compete in the South African Cross Country Trials after only a month of proper training. I placed 4th at the race, which made me feel like I’d won, since the first 5 across the line were promised spots on the South African team for the World Cross Country Championships. However, Athletics South Africa picked a different team, so I decided to shift all my focus towards the Durban Marathon Champs. 

After 5 weeks of meticulous training, I found myself at a windy starting line on the 12th of March, 2023. Conditions were far from perfect, but I went out hard, leading the race until the 39 km mark, when the former winner of the Two Oceans Marathon and Soweto Marathon, Chaltu Bedo Negashu from Ethiopia, tried to pass me. However, the pain of leaving her behind felt negligible compared to what I had to endure in my life so far – the victory of finally breaking that tape, after so many years of struggle and suffering, was a moment that I will cherish forever. I managed to break the course record by more than seven minutes, improving my personal best time to 2:30:31.

Since the start of the pandemic I’ve seen myself accomplish things I’ve never done before, but I’ve also seen my body fail to support me. I have Diabetes Insipidus and hypopituitarism. I know I am at a disadvantage, but I also know I wouldn’t be running if I weren’t. This struggle is what drives me. It gives my life meaning, and purpose. When I run I feel somewhat like I am normal and for that moment I feel strong and capable. I know there will be countless more mountains to climb, but I also know that every single one will equip me better for the next, whatever its unique challenges, be it sickness, global pandemics, or anything in between. You may see me fight and falter, but you will never see me quit. Like my Kenyan coach said, I’m a soldier. I know how to fight. ​

Follow me on my journey as I go against the odds to chase my biggest dreams and push my boundaries. It's never been an easy journey, but I didn't give up and I won't. You may see me struggle but you'll never see me quit.


~ Annie Bothma 


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