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Red blood cells in sports: effects of exercise and training on oxygen supply by red blood cells
Open accessAbstract
During exercise the cardiovascular system has to warrant substrate supply to working muscle. The main function of red blood cells in exercise is the transport of O2 from the lungs to the tissues and the delivery of metabolically produced CO2 to the lungs for expiration. Hemoglobin also contributes to the blood's buffering capacity, and ATP and NO release from red blood cells contributes to vasodilation and improved blood flow to working muscle. These functions require adequate amounts of red blood cells in circulation. Trained athletes, particularly in endurance sports, have a decreased hematocrit, which is sometimes called "sports anemia." This is not anemia in a clinical sense, because athletes have in fact an increased total mass of red blood cells and hemoglobin in circulation relative to sedentary individuals. The slight decrease in hematocrit by training is brought about by an increased plasma volume (PV). The mechanisms that increase total red blood cell mass by training are not understood fully. Despite stimulated erythropoiesis, exercise can decrease the red blood cell mass by intravascular hemolysis mainly of senescent red blood cells, which is caused by mechanical rupture when red blood cells pass through capillaries in contracting muscles, and by compression of red cells e.g., in foot soles during running or in hand palms in weightlifters. Together, these adjustments cause a decrease in the average age of the population of circulating red blood cells in trained athletes. These younger red cells are characterized by improved oxygen release and deformability, both of which also improve tissue oxygen supply during exercise.
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In the citing paper
“it is possible that transfemale athletes experience impaired endurance performance in part due to reduced oxygen transport from the lungs to the working muscles.62”
From How does hormone transition in transgender women change body composition, muscle strength and haemoglobin? Systematic review with a focus on the implications for sport participation (2021) · cites this paper as [62]
Experimental — accuracy not yet measuredIn the citing paper
“Resting muscle consumes ‘only’ 1 ml O2 per minute and per 100 g of tissue, but oxygen consumption can increase up to 50-fold in contracting muscle, when exercising [34], and this enables enhanced performance [35].”
From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [35]
In the citing paper
“During anemia, i.e., when the levels of hemoglobin (the oxygen carrier) are decreased, oxygen delivery is impaired, with consequences for not only cognitive [36] and physical [35] performance, but also perceived fatigue and tiredness [37].”
From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [35]
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Metadata
- Authors
- Mairbäurl, H.
- Affiliations
- Heidelberg University (DE)
- Corresponding author
- Mairbäurl, Heimo
- ORCID
- Mairbäurl, Heimo
- Venue
- Frontiers in Physiology
- Publisher
- Frontiers Media SA
- Published
- 2013
- Volume
- 4
- Pages
- 332-332
- ISSN
- 1664-042X (ISSN-L)
- PMC
- PMC3824146
- OpenAlex
- W2046459032
- Cited by
- 482
- References
- 194
- Citations by year
- 2026: 42 · 2025: 41 · 2024: 60 · 2023: 44 · 2022: 43 · 2021: 45 · 2020: 48 · 2019: 46 · 2018: 28 · 2017: 39 · 2016: 19 · 2015: 16 · 2014: 10
- FWCI
- 3.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Physiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
- Health Sciences › Medicine › Hematology › Blood properties and coagulation
- Keywords
- erythrocytes, physical activity, training, sports anemia, hematocrit, plasma volume, erythropoiesis, intravascular hemolysis, erythrocyte deformability, oxygen delivery, hemoglobin, blood buffering, vasodilation, endurance athletes
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