Iron Deficiency in Athletes

Why is Iron Important for Athletes?

Iron is essential for many bodily functions including oxygen transport, energy metabolism, cognitive and immune function. If iron stores become compromised the body is not able to receive the amount of oxygen required for optimal energy production. For an athlete, this means having an adequate source of iron is imperative for performance as it has the potential to impact aerobic capacity, fatigue levels, recovery, training adaption and general health.

Symptoms of Iron Deficiency in Athletes 

Both elite and recreational athletes can be susceptible to iron deficiency, whether it be related to diet, volume of training, energy expenditure or eating habits. Athletes require 1.3 to 1.7 times higher levels of iron compared to non-athletes as iron is lost through sweat, the gastrointestinal tract, menstruation and sweat. Females are particularly more at risk of iron deficiency or iron deficiency amenia, with statistics considering athletic population being 15-35% for females and 5-11% for males. It is important to note that feelings of fatigue or lethargy are often the first symptoms that an athlete may experience when at risk of iron deficiency and in most cases will require a blood test to confirm this. Although some athletes may not present with any symptoms. These athletes may need to undergo a screening due to having associated risk factors. Other common symptoms include nausea, frequent illness, under performance, shortness of breath, loss of power, “jelly legs”, “light headedness”, loss of endurance, poor mood, and decreased training motivation.

Treatment and Management of Iron Deficiency

Potential Risk Factors for Iron Deficiency

•  Vegan/vegetarian diets
•  High intake of foods that impact the availability of iron such as tea and coffee
•  Poorly managed clinical disorders such as celiac disease or crohn’s
•  Female athlete factors related to menses, growth and pregnancy
•  Iron loss due to internal blood loss, excessive training stress or sweat loss

Indications for an Iron Screening

Why is treatment so important?

Treatment of Iron deficiency may be first suspected by a Physiotherapist during your assessment when they are getting to know the athlete’s training habits and history. If a clinician is suspicious the athlete will then typically be referred on to a sports or general physician for further assessment. Once iron deficiency is confirmed and the cause and associated factors are identified a sports dietician may also become involved. Treatment can involve training modifications, iron supplementation and dietary changes. Hence management of Iron deficiency can involve multiple health professionals to ensure its being appropriately managed to get the athlete back to optimal performance.

Identifying iron deficiency and it’s cause is extremely important as it can also be associated with other health concerns such as relative energy deficiency in sport or RED-s. RED-S encompasses a syndrome where poor health and athletic performance has been affected by a mismatch between energy intake from our diet and the energy cost of sport, daily activity, and growth. It occurs because our energy intake has decreased and/or our exercise load has increased. 

This may occur because of inadequate nutritional knowledge, lack of availability or time constraints preventing the athlete from meeting their energy demands or through the presence of eating disorders. RED-S can affect a multitude of health areas but particularly menstrual health, bone health, metabolic rate and can cause psychological consequences. 

Understanding RED-S and Its Relation to Iron Deficiency

It is important to note that iron-deficiency occurs when there is not enough iron consumed and stored in the body. Not adequately fuelling the body through diet to replace the energy lost through exercise reduces the amount of iron we have available to use. Additionally, being under fuelled affects hormone levels which in turn affects how much iron can be absorbed and utilised by the body. Hence iron deficiency and under fuelling may need to be treated by both dietary and supplementary changes.

How can we help?

If you suspect yourself or your child may be suffering from any of the symptoms discussed above come and see one of our experienced team members at Coast Sport. Whether it’s completing a sports risk assessment, return to play plan, gaining valuable guidance and education or dietary advice on how to best fuel your body we can help. Book in today to address your health and optimise your performance.