She had knee surgery at the start of the year and an "ongoing back issue" that almost wrecked her preparations for the European Championships here.

"I couldn't even walk about two weeks ago," said Campbell.

"I haven’t talked about it while it was happening, but I didn't lift the bar above my head until last Monday and I was never sure I was even going to compete.

"I did no squats, no pulls no deadlifts, nothing."

She came close to failure after missing her first two snatch attempts, and after recovering she posted her lowest total in more than four years on 110-143-253 but it was still enough to take a third straight continental title in the super-heavyweights.

"My team have worked so hard to get me out there on the platform, my family have given me so much support - I love you all," said the 28-year-old Campbell.

The 11 lifters had 28 white lights and only five reds in the snatch, and unfortunately for Campbell two of the reds were alongside her name at 110kg.

That was 12kg lower than her best effort in Bogotá, Colombia in December in the first qualifier for Paris 2024, the International Weightlifting Federation (IWF) World Championships.

"I’d usually take 110 for granted, no problem, but this time it took me to miss twice to get going," she said.

"I expected to be champion and I nearly let it go but I managed to pull it out of the bag."

Things went better after the break, when Campbell came out after everybody else had finished to make 136kg for clean and jerk gold, then 143kg for gold on total before declining her final attempt.

Between her attempts, Campbell settled herself with her headphones on, listening to Caribbean carnival music.

She enjoyed the experience at the Karen Demirchyan Complex - "the best venue we've ever had for a European Championships" - and blew kisses to the large crowd.

"It’s been great here, lovely place, lovely people, I’ve been really surprised," Campbell said.

She will go to Cuba for the next Paris qualifier, the IWF Grand Prix in June, but is likely to wait until the IWF World Championships before lifting again, giving herself plenty of time to get back to full fitness.

Cuba would still count as a "participation" in Paris qualifying if Campbell weighs in, and would leave her with a lengthy period between September and next April to decide on her next move.

The IWF Grand Prix in Qatar in December and next year's European Championships in Turkey in February would be optional, and the IWF World Cup in Thailand a year from now is compulsory for all potential qualifiers.

Second place went to Anastasiia Hotfrid from Georgia, who made her best total since returning to the sport after giving birth to a son, Erhard, who will be four next month.

"It’s like 500 times harder to be a mum and a weightlifter rather than just a weightlifter," said Hotfrid, a world champion in the old 90kg weight category in 2017.

"Erhard is always there at training with me, he wants to be with me all the time."

His dad is there too, because Hotfrid’s personal coach is her husband Denys, an Olympic lifter for Ukraine before he switched nationality.

Hotfrid, who weighed in 30kg lighter than Campbell, returned to training a month after giving birth and took nine months to get back to somewhere near her best.

She lifted at Rio 2016 and will wait on her National Federation's decision about where she goes next in her attempt to qualify for Paris.

Erhard was not watching on television. 

"He misses me so much, we try not to let him see pictures of mum so he doesn’t cry."

Hotfrid won snatch gold and made 117-135-252, ahead of the Ukrainian Valentyna Kisil on 111-133-244.

Meline Gunal of Turkey made 110kg to finish third in the snatch, where Campbell was off the podium, and Sarah Fischer took clean and jerk bronze on 134kg, winning Austria’s second medal of the weekend.