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Iron Deficiency in Athletes: An Update
Abstract
Adequate body stores of iron are necessary for optimal endurance exercise performance. Severe iron depletion resulting in overt iron-deficiency anemia clearly depresses endurance fitness, but it is not clear if milder degrees of iron deficiency (low serum ferritin with normal hemoglobin levels) impair physical capacity. The question is an important one for athletes, particularly females, who are particularly prone to iron deficiency without anemia. This review examines research data, in both animals and humans, which have addressed this issue. Constructing guidelines based on this often-conflicting body of information is difficult. Routine screening is advocated for at-risk athletes, particularly elite-level female competitors in distance sports, and, although controversial, many authorities recommend iron treatment for athletes with hypoferritemia (ferritin <12-20 ng/mL), even without overt anemia. However, “blind” supplementation with oral iron by athletes is not recommended.
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“In addition to insufficient intake, high-intensity sport can lead to ID through other mechanisms, such as increased iron demand, higher iron loss due to micro-trauma and ischemia of the gut, hemolysis, iron loss through increased sweating [12,18,25], and dysregulation of iron absorption and storage by elevated hepcidin levels post-exercise [26].”
From Iron Deficiency and Anemia in Male and Female Adolescent Athletes Who Engage in Ball Games (2023) · cites this paper as [18]
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Haas, J. D., & Brownlie, T. (2001) · The Journal of Nutrition · doi:10.1093/jn/131.2.676s · Cited by 1,186
Serum Transferrin Receptor and Its Ratio to Serum Ferritin in the Diagnosis of Iron Deficiency
Punnonen, K., Irjala, K., & Rajamäki, A. (1997) · Blood · doi:10.1182/blood.v89.3.1052 · Cited by 859 · cited 1×
“Other biomarkers may be useful for accurately gauging adequacy of body iron stores, including transferrin, transferrin saturation, and soluble transferrin receptor.(5) These are neither commonly used in clinical settings nor in routine screening of iron status in athletes, however, and will not be addressed in this re…”
BackgroundIron treatment normalizes cognitive functioning in young women
Murray-Kolb, L. E., & Beard, J. L. (2007) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.3.778 · Cited by 373
Response to exercise after blood loss and reinfusion
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“Similar findings have been reported in subjects undergoing progressive phlebotomies to create anemia.(12) When irondeficiency anemia is corrected in these studies, normal endurance times are restored.”
ResultEffect of iron injections on aerobic-exercise performance of iron-depleted female athletes
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Cited by
Iron considerations for the athlete: a narrative review
Sim, M., Garvican-Lewis, L. A., Cox, G. R., Govus, A., McKay, A. K. A., Stellingwerff, T., & Peeling, P. (2019) · European Journal of Applied Physiology · doi:10.1007/s00421-019-04157-y · Cited by 274
Recommendations and Nutritional Considerations for Female Athletes: Health and Performance
Holtzman, B., & Ackerman, K. E. (2021) · Sports Medicine · doi:10.1007/s40279-021-01508-8 · Cited by 111
The Unexplored Crossroads of the Female Athlete Triad and Iron Deficiency: A Narrative Review
Petkus, D. L., Murray-Kolb, L. E., & De Souza, M. J. (2017) · Sports Medicine · doi:10.1007/s40279-017-0706-2 · Cited by 92
Iron Metabolism: Interactions with Energy and Carbohydrate Availability
McKay, A. K. A., Pyne, D. B., Burke, L. M., & Peeling, P. (2020) · Nutrients · doi:10.3390/nu12123692 · Cited by 51
Iron Deficiency and Anemia in Male and Female Adolescent Athletes Who Engage in Ball Games
Nicotra, D., Arieli, R., Redlich, N., Navot-Mintzer, D., & Constantini, N. W. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12030970 · Cited by 26
Metadata
- Authors
- Rowland, T.
- Affiliations
- Department of Pediatrics, Baystate Medical Center, Springfield, Massachusetts
- Venue
- American Journal of Lifestyle Medicine
- Publisher
- SAGE Publications
- Published
- 2012-01-20
- Volume
- 6
- Issue
- 4
- Pages
- 319-327
- ISSN
- 1559-8276
- 1559-8284
- Cited by
- 28
- References
- 7
- Language
- en
- Licence
- journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
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