Iron is an essential mineral that is crucial to health and well-being. Every person needs iron: Without this important nutrient, the body cannot make hemoglobin, the substance in red blood cells that carries oxygen from our lungs to our tissues. When our tissues do not get enough oxygen, the body is unable to function as it should.
In other words, we should all be aware of our iron intake and try to obtain enough iron through our diet, using supplements when appropriate to meet our body’s needs. But athletes, in particular, would be wise to pay special attention to ensure they have sufficient iron levels. If you are an athlete, read on to discover why you are at increased risk for iron deficiency and to learn how you can pump up your iron stores.
Why Is Iron Important for Athletes?
As mentioned above, iron is the central component of hemoglobin, the protein in red blood cells that transports oxygen from the body’s lungs to all of its tissues—including muscle tissues—and then returns carbon dioxide from the tissues back to the lungs. Iron is also a component of myoglobin, which stores oxygen in muscle cells, and of cytochrome enzymes that are involved in the production of energy.
What does all of this mean? Put simply, iron is critical to proper muscle functioning and plays a vital role in providing our bodies with the energy we need to move.
Athletes place high demands on their muscles while training and competing and have unique energy requirements. The more physically active a person is, the more oxygen their body needs. Intense training also increases red blood cell production. Thus, iron is especially important for athletes. Without enough iron, athletic performance may be impaired. Not only might an athlete’s muscles not function optimally, but they may feel more fatigued in general and unable to work out or compete at their maximum.
Prevalence of Iron Deficiency in Athletes
Instances of low iron levels and of iron deficiency anemia—a condition in which there are not enough healthy red blood cells to transport oxygen throughout the body, which develops due to insufficient iron—appear to be higher among athletes than the rest of the population.1
Though the exact figures vary depending on the specific source, it is estimated that anywhere between 20% and 50% of female athletes and 4% to 50% of male athletes are deficient in iron.2
Types of Athletes at Increased Risk for Iron Deficiency
Three groups appear to be especially vulnerable to developing low iron levels:1
- Female athletes;
- Long-distance runners, as well as those competing in other endurance sports and training at a high intensity; and
- Vegetarian athletes.
Female athletes who eat a vegetarian diet seem to be at the greatest risk for insufficient iron.
Why are these particular groups at risk for iron deficiency? To begin with, it is important to know that the body cannot produce its own iron. This mineral must be obtained through diet or supplements.
Sources of Iron
Iron can be found in both animal-based foods and plant-based foods. Plant foods are sources of non-heme iron and are ideal for those following a vegetarian or vegan eating plan. However, non-heme iron is less effectively absorbed by the body than heme iron (more in a minute). Plus, plant sources typically have slightly lower levels of iron content per serving than their animal counterparts. Animal-based iron sources are a combination of non-heme and heme iron. Heme iron itself is generally more easily absorbed.
The majority of our iron intake is non-heme iron. However, though heme iron typically constitutes only around 10% of our total dietary iron intake, it may provide up to one-third of the iron the body absorbs from food.1 This is why vegetarian athletes—who do not consume heme iron—may be at a greater risk for iron deficiency, especially if they are further watching what they eat and limiting food consumption overall, or relying on pasta and carb-rich foods.
Even non-vegetarian athletes may be apt to avoid iron-rich foods such as red meat—because of the amount of fat, cholesterol, and sodium these meats contain—and to engage in calorie restriction as well.
Women may be more predisposed to iron deficiency in general due to blood loss during menstruation.
Why Are Athletes at Greater Risk for Low Iron?
Aside from dietary choices, there are several reasons why athletes appear to be more likely to develop low iron levels than other healthy but sedentary individuals. According to the research, iron deficiency is common in athletes for the following reasons.1,3,4
Hematuria: Athletes tend to experience hematuria, or blood loss through urine, after exertion, and especially after intense workouts. This type of blood loss may occur more often in endurance runners. When the foot strikes a hard running surface, that impact can cause red blood cells to rupture. Blood lost in this way may lead to iron deficiency or iron deficiency anemia.
Gastrointestinal bleeding: Distance runners especially, but other athletes as well, may experience gastrointestinal bleeding. Loss of blood in this manner can eventually lead to low iron levels or iron deficiency anemia.
Heavy sweating: Iron is also lost through sweat. Because athletes sweat heavily during workouts and competitive events, it is important for them to replenish their iron stores either through food or supplements, or a combination of these nutritional approaches.
Hepcidin: The research also suggests that athletes are at increased risk for iron deficiency because of a hormone called hepcidin, which appears to spike after intense physical activity. Hepcidin reduces blood iron levels. Importantly, hepcidin levels seem to peak between three and six hours after a hard workout. Meaning, many athletes who try to consume iron-rich meals in that time might not be absorbing the nutrient at all.
What Are the Symptoms of Iron Deficiency in Athletes?
Athletes who develop low iron levels can experience the same symptoms as healthy, sedentary individuals. They may also notice signs of low iron more closely related to their training.
General signs and symptoms of iron deficiency include:5
- Fatigue, ranging from mild to severe
- Low energy during the menstrual cycle
- Pale, dry skin and mucous membranes
- Cracked corners of the mouth
- Brittle nails and hair, including hair loss
- Decreased memory, attention, and learning performance
Signs and symptoms of iron deficiency specific to athletes include:6
- Decline in athletic capacity, including loss of endurance
- Decreased exercise performance
- Higher-than-normal resting heart rate or exercising heart rate (athletes usually have a lower resting heart rate than more sedentary individuals)
- Shortness of breath while exercising
- Frequent injury
- Loss of interest in exercise
Note that many of the symptoms of iron deficiency can also be caused by over-training, making misdiagnosis common. A blood test can confirm low iron levels.
Eating More Iron: Foods That Boost Iron Levels
There are two nutritional strategies for increasing iron levels: diet and dietary supplements, the latter of which will be discussed more in the next section.
As mentioned above, getting enough iron through diet alone can be difficult for many athletes, who often eschew certain foods and monitor their caloric intake. And as has also been mentioned previously, levels of the iron-reducing hormone hepcidin can remain increased for hours after a workout, making it difficult for the body to absorb iron from food during that time. For athletes who train consistently, there may be few windows in which they can properly obtain dietary iron, making supplements a prudent choice.
Vegetarian athletes, in particular, may need to increase their intake of iron-rich plant-based foods in order to absorb enough iron to maintain adequate iron levels and/or consider supplementation.
The following animal and plant foods are good sources of heme and non-heme iron:7
- Brown rice
Eating high-iron foods alongside other foods rich in vitamin C—such as citrus fruits, peppers, and broccoli—is believed to help enhance the body’s absorption of iron.
The Benefits of Iron Supplementation
Iron supplements can be used to help reverse low iron levels and to treat iron deficiency anemia in athletes. In fact, research has shown that iron supplementation can reverse any iron-deficiency-related athletic losses and improve exercise performance.
In a landmark meta-analysis on the topic, scientists concluded that iron supplementation benefits women’s physical performance, both in terms of maximal aerobic capacity and efficiency of submaximal exercise, as well as improves strength.8
Advantages of Floradix® Iron Supplements
Floradix® iron supplements include the best-selling natural liquid iron supplement in the US today, Floradix® Iron + Herbs.† They may help people experiencing iron deficiency, as they have been reported to support the formation of healthy red blood cells.* Floradix iron supplements have been trusted by customers for decades, as they are gentle to digest and easily absorbed—conventional iron supplements often are not. Floradix iron supplements also offer these additional benefits:
- Free of artificial additives, synthetic preservatives, alcohol, and lactose
- Kosher, non-GMO, and vegetarian
- Environmentally friendly packaging
- Available in multiple formats, including liquids, tablets, and a vegan, yeast-free, and gluten-free formula
Iron Supplement Precautions
If you are an athlete who believes you may have low iron, you should talk with your doctor before adding an iron supplement to your daily regimen. Your doctor may recommend that your iron levels be tested via blood work. This testing can verify if you are in fact deficient and in need of supplementation, and if so, the appropriate dose of iron to take in supplement form to help return your iron levels to a healthy range.*
After you begin supplementing with iron, you should also have your iron levels re-checked every three to four months, as you may need to discontinue use once your iron levels are within a healthy range. While iron deficiency has detrimental effects on the body, the reverse is also true, as too much iron can also cause health issues.
- John Beard and Brian Tobin, “Iron Status and Exercise,” The American Journal of Clinical Nutrition 72, no. 2 (August 2000): 594S-597S, https://doi.org/10.1093/ajcn/72.2.594S.
- Holly J. Benjamin, MD, “Iron Strength: What Endurance Athletes Should Know About Iron Deficiency Anemia and Ferritin Screening,” Team USA, August 19, 2019, https://www.teamusa.org/USA-Triathlon/News/Blogs/Multisport-Lab/2019/August….
- Melvin H. Williams, “Dietary Supplements and Sports Performance: Minerals,” Journal of the International Society of Sports Nutrition 2 (2005), https://jissn.biomedcentral.com/articles/10.1186/1550-2783-2-1-43.
- Mia K. Newlin et al. “The Effects of Acute Exercise Bouts on Hepcidin in Women,” International Journal of Sport Nutrition and Exercise Metabolism 22, no. 2 (April 2012): 79-88, https://doi.org/10.1123/ijsnem.22.2.79.
- Mayo Clinic Staff, “Iron Deficiency Anemia,” Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/sympt… “Iron Deficiency Anemia,” National Heart, Lung, and Blood Institute, https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia.
- Jason Brumitt, Linda McIntosh, and Richard Rutt, “Comprehensive Sports Medicine Treatment of an Athlete Who Runs Cross-Country and is Iron Deficient,” North American Journal of Sports Physical Therapy 4, no. 1 (2009): 13-20, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953317.; Natalie A. Suedekum and Robert J. Dimeff, “Iron and the Athlete,” Current Sports Medicine Reports 4, no. 4 (2005): 199-202, https://doi.org/10.1097/01.CSMR.0000306207.79809.7f.
- “Iron Fact Sheet for Health Professionals,” National Institutes of Health Office of Dietary Supplements, https://ods.od.nih.gov/factsheets/Iron-HealthProfessional.; “Iron-Rich Foods and Anemia: Management and Treatment,” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/14621-iron-rich-foods-and-an….
- Sant-Rayn Pasricha et al. “Iron Supplementation Benefits Physical Performance in Women of Reproductive Age: A Systematic Review and Meta-Analysis,” The Journal of Nutrition 144, no. 6 (June 2014): 906-914, https://doi.org/10.3945/jn.113.189589.
† SPINS Vitamins & Minerals Iron: Natural Channel 13 Quads End 2020-Dec-27