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Cited by 111Iron Metabolism and DisordersExercise and Physiological ResponsesSports Performance and Training

Iron balance and iron supplementation for the female athlete: A practical approach

Pedlar, Charles R, Brugnara, Carlo, Bruinvels, Georgie, Burden, Richard·2018·European Journal of Sport Science
DOI 10.1080/17461391.2017.1416178
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Abstract

Maintaining a positive iron balance is essential for female athletes to avoid the effects of iron deficiency and anaemia and to maintain or improve performance. A major function of iron is in the production of the oxygen and carbon dioxide carrying molecule, haemoglobin, via erythropoiesis. Iron balance is under the control of a number of factors including the peptide hormone hepcidin, dietary iron intake and absorption, environmental stressors (e.g. altitude), exercise, menstrual blood loss and genetics. Menstruating females, particularly those with heavy menstrual bleeding are at an elevated risk of iron deficiency. Haemoglobin concentration [Hb] and serum ferritin (sFer) are traditionally used to identify iron deficiency, however, in isolation these may have limited value in athletes due to: (1) the effects of fluctuations in plasma volume in response to training or the environment on [Hb], (2) the influence of inflammation on sFer and (3) the absence of sport, gender and individually specific normative data. A more detailed and longitudinal examination of haematology, menstrual cycle pattern, biochemistry, exercise physiology, environmental factors and training load can offer a superior characterisation of iron status and help to direct appropriate interventions that will avoid iron deficiency or iron overload. Supplementation is often required in iron deficiency; however, nutritional strategies to increase iron intake, rest and descent from altitude can also be effective and will help to prevent future iron deficient episodes. In severe cases or where there is a time‐critical need, such as major championships, iron injections may be appropriate.

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  • Following ovulation, increases in progesterone increase hepcidin expression, which limits iron utilization.

    “Following ovulation, increases in progesterone increase hepcidin expression, which limits iron utilization [322].”

    From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [322]

    In “Iron balance and exercise performance” (pp. 5–6), the paper says hepcidin rebounds later in the menstrual cycle and that increased hepcidin reduces iron absorption. It does not say that post-ovulation progesterone increases hepcidin, or establish that mechanism for the later-cycle rebound. (LLM, conf=0.87)

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Research works printed but not linked: 1

  1. Viteri, F. E. (1994). The consequences of iron deficiency and anemia in pregnancy Nutrient regulation during pregnancy, lactation, and infant growth (pp. 127-139): Springer.

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Authors
Pedlar, C. R., Brugnara, C., Bruinvels, G., & Burden, R.
Affiliations
  • St Mary's University Twickenham London (GB)
  • Boston Children's Hospital (US)
Corresponding author
Pedlar, Charles R
ORCID
Venue
European Journal of Sport Science
Publisher
Wiley
Published
2017-12-27
Volume
18
Issue
2
Pages
295-305
ISSN
  • 1536-7290 (ISSN-L)
  • 1746-1391
DOI
10.1080/17461391.2017.1416178
OpenAlex
W2776146123
Cited by
111
References
67
Citations by year
2026: 5 · 2025: 15 · 2024: 9 · 2023: 16 · 2022: 21 · 2021: 14 · 2020: 13 · 2019: 13 · 2018: 5
FWCI
1.35
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • European Journal of Sport Science (publishedVersion)
  • PubMed (publishedVersion)
  • St Mary's University Repository (St Mary's University Twickenham London) (acceptedVersion)
Topics
  • Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
Keywords
iron balance, iron supplementation, female athletes, iron deficiency, anemia, hepcidin, hemoglobin, serum ferritin, menstrual blood loss, menorrhagia, iron overload, altitude, inflammation, iron status assessment, iron injection, iron intake
MeSH terms
Iron Deficiencies, Female, Hemoglobins, Humans, Menstruation, Nutritional Requirements, Exercise, Iron, Dietary, Dietary Supplements, Athletic Performance, Athletes, Sports Nutritional Physiological Phenomena

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