Cited by 170Iron Metabolism and DisordersExercise and Physiological ResponsesErythropoietin and Anemia Treatment

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Iron deficiency in sports-definition, influence on performance and therapy

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Clénin, German, Cordes, Mareike, Huber, Andreas, Schumacher, Yorck Olaf, Noack, Patrick, Scales, John, Kriemler, Susi·2015·Swiss Medical Weekly

DOI 10.4414/smw.2015.14196

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Abstract

Iron deficiency is frequent among athletes. All types of iron deficiency may affect physical performance and should be treated. The main mechanisms by which sport leads to iron deficiency are increased iron demand, elevated iron loss and blockage of iron absorption due to hepcidin bursts. As a baseline set of blood tests, haemoglobin, haematocrit, mean cellular volume, mean cellular haemoglobin and serum ferritin levels help monitor iron deficiency. In healthy male and female athletes >15 years, ferritin values <15 mcg are equivalent to empty, values from 15 to 30 mcg/l to low iron stores. Therefore a cut-off of 30 mcg/l is appropriate. For children aged from 6-12 years and younger adolescents from 12-15 years, cut-offs of 15 and 20 mcg/l, respectively, are recommended. As an exception in adult elite sports, a ferritin value of 50 mcg/l should be attained in athletes prior to altitude training, as iron demands in these situations are increased. Treatment of iron deficiency consists of nutritional counselling, oral iron supplementation or, in specific cases, by intravenous injection. Athletes with repeatedly low ferritin values benefit from intermittent oral substitution. It is important to follow up the athletes on an individual basis, repeating the baseline blood tests listed above twice a year. A long-term daily oral iron intake or i.v. supplementation in the presence of normal or even high ferritin values does not make sense and may be harmful.

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Authors: Clénin, G., Cordes, M., Huber, A., Schumacher, Y. O., Noack, P., Scales, J., & Kriemler, S.
Affiliations: Kantonsspital Aarau (CH)
Qatar Orthopaedic and Sports Medicine Hospital (QA)
University of Zurich (CH)
ORCID: Huber, Andreas
Kriemler, Susi
Venue: Swiss Medical Weekly
Publisher: SMW Supporting Association
Published: 2015-10-18
Volume: 145
Issue: 4344
Pages: w14196
ISSN: 0036-7672 (ISSN-L)
1424-3997
DOI: 10.4414/smw.2015.14196
OpenAlex: W1883754188
Cited by: 170
References: 96
Citations by year: 2026: 12 · 2025: 24 · 2024: 16 · 2023: 31 · 2022: 18 · 2021: 13 · 2020: 15 · 2019: 15 · 2018: 17 · 2017: 6 · 2016: 2 · 2015: 1
FWCI: 1.30
Type: journal article
Language: en
Open access: diamond
doi.org
Licence: cc-by-nc-sa
creativecommons.org/licenses/by-nc-sa/4.0 (unspecified)
Locations: Swiss Medical Weekly (publishedVersion, cc-by-nc-sa)
PubMed (publishedVersion)
Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc-nd)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by-nc-nd)
Zurich Open Repository and Archive (University of Zurich)
Topics: Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
Health Sciences › Medicine › Hematology › Erythropoietin and Anemia Treatment
Keywords: iron deficiency, athletes, physical performance, serum ferritin, hepcidin, iron absorption, iron supplementation, altitude training, iron deficiency anemia, nutrition counseling, children and adolescents
MeSH terms: Adolescent, Adult, Child, Female, Ferritins, Hematocrit, Hemoglobins, Humans, Iron, Male, Anemia, Iron-Deficiency, Iron, Dietary, Dietary Supplements, Athletic Performance, Young Adult, Athletes

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Iron deficiency in sports-definition, influence on performance and therapy

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