A normal ferritin level can falsely suggest ferritin is within a normal range—but this does not mean the ferritin level is appropriate for an athlete to feel well.

People who are menstruating need 18 milligrams of iron per day, according to the National Institutes of Health. And people who have iron deficiency need more iron than the standard recommended amount. Hemochromatosis causes toxic amounts of iron to build up in your body. There are also other reasons to work with your health care provider while taking iron supplements.

For example, too much iron can cause painful stomach cramps. You should take iron supplements only under the care of your provider. But if you do need to take iron, there are some common pitfalls to avoid. Here are tips for taking iron supplements:.

Certain plant foods contain some iron, too. He recommends that all athletes meet with a dietitian who specializes in sports nutrition.

It can also be a marker for overall health and wellbeing, and it prompts us to look at ways to improve nutrition. In addition to treating injuries, sports dietitians on staff can help you navigate the nutritional demands of an active life. Request an appointment, or learn more about Sports Medicine at Mass General Brigham and the teams we treat.

Skip to cookie consent Skip to main content Skip to alerts Skip to pause carousel. About Us Newsroom Iron Deficiency in Female Athletes. More alert details. Iron Deficiency in Female Athletes Contributor Adam Tenforde, MD. Jun 23, However, there is controversy about whether iron supplementation in athletes with ID alone is helpful.

The decision to start iron supplementation in ID should be shared between the athlete, physician, and potentially, a dietician. Iron supplementation without knowing iron levels is not recommended.

Iron is best absorbed in the form of food, as opposed to iron supplements, so increasing the intake of iron-rich foods is important to treating both ID and IDA. Iron-rich foods include animal protein such as red meat, chicken, and fish, as well as non-animal sources, including iron-enriched cereals and pastas, beans, and dark-green leafy vegetables.

Iron supplement absorption is improved with vitamin C supplementation. Orange juice without calcium is a great option to take with the supplement.

Iron supplements should not be taken with milk, coffee or calcium tablets, as these can reduce the absorption of iron. Finally, iron supplements can cause constipation, so increasing dietary fiber intake and considering a fiber supplement is important. Prevention Eating a healthy diet with foods rich in iron is a good way to help maintain normal iron stores in the body.

As meat is a good source of iron, athletes who adhere to a vegetarian or vegan diet should be particularly careful to ensure adequate dietary iron consumption.

Return to Play Athletes with symptoms like weakness, shortness of breath, or heart palpitations will likely have difficulty in competition, and exercise restriction may be considered until the athlete feels better. As iron levels increase, the athlete will likely experience improved symptoms and expect to return to a normal level of athletic performance.

Authors: AMSSM Members Kyle V. Goerl, MD; Cindy J. Chang, MD. DellaValle DM. If your deficiency is severe, you may need supplements.

Never use iron supplements unless under the supervision of your healthcare provider, as too much iron can cause irreversible damage and a higher risk of cancer and heart disease. The RDA for women and teenagers is 15 milligrams per day. Men should consume 10 mg. Endurance athletes may need slightly more.

You can get iron in both animal and plant foods, but the iron in animal sources has an absorption rate of about 20 to 30 percent, while it reaches up to 10 percent for plants. You can also increase the amount of iron in foods you eat by cooking with a cast iron skillet especially if cooking acidic foods.

Iron absorption from any foods, whether plant or animal, is decreased if they are accompanied at meals by caffeine.

However, adding fruit citrus fruit in particular , to meals enhances iron absorption. The best sources of iron in the diet include: Lean red meat, iron-fortified breakfast cereal, nuts, and legumes, combined these with foods high in vitamin C. Smolin L, Grosvenor M. Nutrition: Science and Applications 4th Edition.

Alaunyte I, Stojceska V, Plunkett A. Iron and the female athlete: a review of dietary treatment methods for improving iron status and exercise performance. J Int Soc Sports Nutr. Ottomano C, Franchini M. Sports anaemia: facts or fiction? Blood Transfus. Anemia Healthy Lifestyle Changes.

National Institutes of Health. US Department of Health and Human Services. Iron-Deficiency Anemia. American Society of Hematology. Kotze MJ, Van velden DP, Van rensburg SJ, Erasmus R. Pathogenic Mechanisms Underlying Iron Deficiency and Iron Overload: New Insights for Clinical Application.

Google Scholar. Zachary Pounders , Zachary Pounders. Aditi Singh , Aditi Singh. John Hospital, Detroit, MI. Joseph Attallah , Joseph Attallah. Zyad Kafri , Zyad Kafri. Blood Supplement 1 : — Split-Screen Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Request Permissions.

Cite Icon Cite. toolbar search Search Dropdown Menu. toolbar search search input Search input auto suggest. Figure 1. View large Download PPT. No relevant conflicts of interest to declare.

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A four week iron-rich diet, which provided The study however did not assess their performance during the trial and hence, no conclusions can be drawn as to any possible effects on exercise performance.

A study by Lyle et al. Furthermore, the dietary intervention group showed the greatest improvements in exercise performance highlighting the possibility that dietary iron may play a role during exercise adaptation.

A dietary counselling intervention study conducted by Anschuetz et al. Nevertheless, the authors suggested that the diet composition, in particular the presence of enhancers of non-haem iron absorption, has a significant influence on iron absorption in this population.

The importance of iron bioavailability in dietary intervention was also studied by other researchers, who investigated the effects of the addition of lean beef to the diets of distance runners, during a competitive season [ 13 ].

The authors reported no significant differences between the intervention and control groups in iron parameters during a period of 8 weeks.

In fact, some of the iron status indices were found to have decreased in both groups, which may have been due to their intensive training regimens. The most recent study investigating iron status in female athletes used dietary intervention, incorporating a novel and naturally iron-rich Teff bread into the daily diets of female runners [ 1 ].

A six week dietary intervention, which provided The authors did however report significant correlations between the increase in dietary iron intake and changes in serum ferritin concentration.

In addition, inadequate dietary iron intake and in particular the level of absorbable and bioavailable iron in the diet, may further contribute to depletion of stored iron.

Practical considerations for the maintenance or improvement of iron in female athletes should incorporate dietary modifications centred on healthy eating practices with particular focus on increasing total dietary iron, especially haem-iron intake, and improving iron bioavailability by altering meal composition.

For instance, iron-rich foods can be consumed with fruit and vegetables, enhancing iron absorption due to the presence of higher levels of Vitamin C. Similarly, the intake of iron absorption inhibitors such as tannins in tea or coffee or calcium in milk, can be decreased or at least avoided in the same meal.

To conclude, the majority of research studies support the hypothesis of the beneficial effect of dietary iron interventions on the balance of iron in iron-depleted female athletes. However, the direct impact on exercise performance among female athletes is unclear.

Nevertheless, there seems to be evidence that dietary iron interventions may assist in maintaining iron status in female athletes, especially during intensive training and competition regimens. Alaunyte I, Stojceska V, Plunkett A, Derbyshire E. Dietary iron intervention using a staple food product for improvement of iron status in female runners.

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You can also search for this author in PubMed Google Scholar. Correspondence to Valentina Stojceska. All the authors declare that there are no competing financial, professional or personal interests that might have influenced the performance or presentation of the work described in this manuscript.