Iron deficiency and recovery time in athletes -
Heavy sweating: Iron is also lost through sweat. Because athletes sweat heavily during workouts and competitive events, it is important for them to replenish their iron stores either through food or supplements, or a combination of these nutritional approaches.
Hepcidin: The research also suggests that athletes are at increased risk for iron deficiency because of a hormone called hepcidin, which appears to spike after intense physical activity. Hepcidin reduces blood iron levels. Importantly, hepcidin levels seem to peak between three and six hours after a hard workout.
Meaning, many athletes who try to consume iron-rich meals in that time might not be absorbing the nutrient at all. Athletes who develop low iron levels can experience the same symptoms as healthy, sedentary individuals.
They may also notice signs of low iron more closely related to their training. Note that many of the symptoms of iron deficiency can also be caused by over-training, making misdiagnosis common. A blood test can confirm low iron levels. There are two nutritional strategies for increasing iron levels: diet and dietary supplements, the latter of which will be discussed more in the next section.
As mentioned above, getting enough iron through diet alone can be difficult for many athletes, who often eschew certain foods and monitor their caloric intake. And as has also been mentioned previously, levels of the iron-reducing hormone hepcidin can remain increased for hours after a workout, making it difficult for the body to absorb iron from food during that time.
For athletes who train consistently, there may be few windows in which they can properly obtain dietary iron, making supplements a prudent choice.
Iron supplements can be used to help reverse low iron levels and to treat iron deficiency anemia in athletes. In fact, research has shown that iron supplementation can reverse any iron-deficiency-related athletic losses and improve exercise performance.
Floradix iron supplements also offer these additional benefits:. If you are an athlete who believes you may have low iron, you should talk with your doctor before adding an iron supplement to your daily regimen. Your doctor may recommend that your iron levels be tested via blood work. This testing can verify if you are in fact deficient and in need of supplementation, and if so, the appropriate dose of iron to take in supplement form to help return your iron levels to a healthy range.
After you begin supplementing with iron, you should also have your iron levels re-checked every three to four months, as you may need to discontinue use once your iron levels are within a healthy range. While iron deficiency has detrimental effects on the body, the reverse is also true, as too much iron can also cause health issues.
Skip to content. F7CE6FEFB-AEBB5D Back to all posts. Why Is Iron Important for Athletes? Prevalence of Iron Deficiency in Athletes Instances of low iron levels and of iron deficiency anemia—a condition in which there are not enough healthy red blood cells to transport oxygen throughout the body, which develops due to insufficient iron—appear to be higher among athletes than the rest of the population.
Female athletes who eat a vegetarian diet seem to be at the greatest risk for insufficient iron. Sources of Iron Iron can be found in both animal-based foods and plant-based foods. Why Are Athletes at Greater Risk for Low Iron? What Are the Symptoms of Iron Deficiency in Athletes?
By Elizabeth Quinn Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.
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Medically reviewed by Jason DelCollo, DO. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
How Is Iron-Deficiency Anemia Treated? National Heart, Lung, and Blood Institute, March 26, Alaunyte I, Stojceska V, Plunkett A.. doi: eCollection See Our Editorial Process. Meet Our Medical Expert Board. Because iron deficiency is so common among athletes, particularly female athletes, it is critical that sports medicine staff members and coaches know the facts about iron and performance.
Below is practical information on iron deficiency designed to help you detect and treat iron deficiency in your athletes. When an athlete is operating without adequate iron, less oxygen is delivered to muscles, maximal oxygen consumption VO 2 max drops, and performance suffers.
They often turn over more iron due to utilizing more oxygen. And because they also lose iron through menstruation, female athletes are particularly at risk for deficiency. When an athlete is not getting enough iron to maintain his or her iron stores, iron deficiency will develop and progress through three stages: depleted iron stores but functional iron is unchanged ; early functional iron deficiency without anemia; and iron-deficiency anemia.
In the first two stages, hemoglobin appears normal, so the condition often goes undetected or is dismissed as inconsequential in the absence of anemia. Animal studies have shown that symptoms show up at this stage because iron-containing oxidative enzymes and cytochromes have already become less active.
The hallmark symptom of iron deficiency anemia is fatigue that worsens with exertion. Since fatigue is a common complaint of athletes and can have many different causes such as other nutritional imbalances, illness, stress, or mental health concerns , the exertional component of iron deficiency fatigue is the key indicator.
Look for fatigue that worsens with exercise. If an athlete complains of fatigue throughout the day, but feels fine during workouts, the cause is likely not exclusively iron deficiency.
Anemia is often perceived as a problem that only female endurance athletes need to worry about, but recent research has shown that iron deficiency can occur in athletes in any sport at any level, male or female.
One recent study found that 25 to 35 percent of adolescent and adult females competing in a variety of sports were iron deficient. The same study found that 11 percent of males competing in a variety of sports were iron deficient, and males competing in certain sports appear to be more at risk: Fifteen percent of male basketball players and 36 percent of elite male gymnasts in the study were iron deficient.
At the University of Florida, we saw a significant number of cases of iron deficiency anemia in football and soccer players and in gymnastics athletes. While any athlete can develop problems with iron, certain athletes do fall into high-risk categories:. The FDA recommends that women 18 to 50 years of age get 18 mg of iron per day.
The RDA for men is eight mg per day. However, because of their high iron turnover, we recommend that all endurance or intensely trained athletes, both male and female, aim for 18 mg a day. The best way to help athletes protect their crucial iron stores is by helping them choose a diet that supplies adequate iron from a variety of sources.
More and more non-meat iron-fortified products have become available recently, ranging from cereals to sports bars to breads e. Athletes who eat meat should focus on getting iron from animal sources, since the iron in animal products which contains hemoglobin is absorbed better than iron from plant sources called non-heme iron , which contains no hemoglobin.
Consuming three to four small servings of beef per week is effective in increasing iron stores for many athletes. Vegetarian athletes can also meet their iron needs through diet, but it takes significant effort and planning. Some nutritionists feel that vegetarian athletes should aim for an iron intake as high as 24 mg per day since their iron sources are not as bioavailable readily absorbed.
It may be helpful to explain to vegetarian athletes why they need to pay particular attention to their iron intake by using the following example: A one-cup serving of raw spinach contains six mg of iron, but only 0.
In contrast, a three-ounce serving of steak contains less iron—only four mg—but 50 percent of that is absorbed in the intestine, for an actual iron intake of two mg.
These athletes also need to be particularly careful to get adequate dietary iron. In addition to consuming more iron, both vegetarian and meat-eating athletes can take steps to enhance the iron their bodies absorb from non-heme sources. One of the best ways to accomplish this is by combining non-heme iron sources with foods high in vitamin C.
Easy examples include:. Preparing non-heme iron foods in cast iron cookware can significantly increase iron content.
For example, using a griddle made of cast iron will add extra iron to foods like pancakes, French toast, scrambled eggs, and stir fry. For example, drinking tea or coffee with iron-rich foods may impair absorption. Similarly, the phytates present in some grains and vegetables can reduce iron absorption.
It is also recommended that iron supplements be taken at a separate time from calcium supplements and even calcium-containing foods because calcium can inhibit iron absorption.
Athletes may be advised to not select calcium-fortified orange juice if their intent is to use the juice to enhance iron absorption. As an added dietary insurance policy, many sports nutritionists recommend a multivitamin that contains iron. Look for a multivitamin from a reputable company that contains approximately 50 percent of the iron Daily Value 9 mg for men and percent of the iron Daily Value 18 mg for women.
Examples of these include Theragran-M or Centrum for males and One-a-Day Women for females. However, caution your athletes not to become too dependent on supplements for achieving their iron needs.
Remind them that even though their supplement contains a high percentage of iron and is an excellent back-up, not all of the iron is well-absorbed, so they still need to focus on dietary sources. If you are working with an athlete who has symptoms consistent with iron deficiency, they should be referred for blood work and further evaluation.
Many insurance companies will pay at least a portion of lab expenses for iron analysis when symptoms are present. Blood tests for iron depletion most commonly measure serum ferritin. Ferritin is a measure of hepatic liver iron stores. Depleted ferritin can be associated with decreased performance.
Many sports medicine professionals aim for a higher range with athletes because iron stores are so critical to health and performance and can be depleted fairly rapidly through rigorous training. It is worth mentioning that ferritin is an acute-phase protein that can be elevated in response to inflammation, hard exercise in an untrained person, or illness.
Thus, if a ferritin test comes back high in the presence of these circumstances, it should be re-evaluated after one week. Athletes whose iron deficiency has progressed to iron deficiency anemia may also have blood tests that show hemoglobin and hematocrit below the normal range.
Hemoglobin is the protein in red blood cells that carries oxygen from the lungs throughout the body. Iron is a critical structural component of hemoglobin and when iron is inadequate, hemoglobin can become diminished. Hematocrit reflects the actual percentage of red blood cells in the blood.
When hematocrit is low, aerobic function is likely diminished.
Enhancing cognitive flexibility is an Iron deficiency and recovery time in athletes mineral Nitric oxide and weight loss is crucial to health and kn. Every person needs iron: Without this important nutrient, recoverh body cannot make hemoglobin, athltees substance in red tike cells that carries Iron deficiency and recovery time in athletes from our lungs tims our tissues. When our tissues do not get enough oxygen, the body is unable to function as it should. But athletes, in particular, would be wise to pay special attention to ensure they have sufficient iron levels. If you are an athlete, read on to discover why you are at increased risk for iron deficiency and to learn how you can pump up your iron stores. Iron is also a component of myoglobin, which stores oxygen in muscle cells, and of cytochrome enzymes that are involved in the production of energy.Iron deficiency and recovery time in athletes -
Generally speaking, this is due to iron losses exceeding iron intake and absorption. Early on in the disease, athletes will have ID with normal hemoglobin levels, while in later or more severe phases of the disease they will develop IDA.
A 23 year old female track athlete at a division 1 university presents with increasing fatigue and decreasing performance over the last few months of training. She is a vegan but has met with a dietician who told her she was consuming enough calories.
There have been no changes in her training program. She has no history of stress fractures and has a normal body habitus.
Her point of care glucose is normal. Which of the following is the most likely diagnosis? A Iron Deficiency Anemia B Overtraining Syndrome C Diabetes Mellitus D Relative Energy Deficiency in Sport. It is important to consider other causes of fatigue, malaise and decreased exercise performance.
Examples would include relative energy deficiency in sport, female athlete triad, hypothyroidism, diabetes, overtraining syndrome, sleep dysfunction and depression among many others. Iron is not synthesized by the human body and must be replenished by dietary intake.
Dietary iron is difficult to replenish even in the non-athlete. This puts vegetarians at increased risk of ID Björn-Rasmussen Treatment is primarily aimed at iron supplementation and is generally an oral route.
Indications for treatment are any degree of anemia and ferritin below normal cutoffs. The biggest side effect is gastrointestinal distress which makes compliance challenging Tolkien The best available evidence says that to avoid this GI toxicity, athletes should take mg every other day and will still have a similar increase in iron stores with less total iron ingested McCormick To maximize absorption, athletes should consume their supplement in the morning, 30 minutes prior to exercise to help potentiate absorption McCormick There are other oral formulations which are less commonly used but may be promising for future management.
Answer A is the correct answer. This vignette is most consistent with iron deficiency anemia. The fatigue and decreased performance could be attributable to any of the answers. A normal blood glucose excludes diabetes. Overtraining syndrome and relative energy deficiency in sport are unlikely given the correct calorie intake, no changes in her training, no other stress related injuries and a normal body habitus.
Her symptoms, sport of choice, gender and choice of veganism put her at high risk of iron deficiency. Because of the decrease in performance and fatigue she is likely anemic at this point. The patient needs serum hemoglobin and ferritin levels checked and perhaps a further workup if the diagnostic picture is unclear.
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Case Question. Iron Deficiency Anemia. Iron is a critical component of heme formation, the protein chain responsible for carrying oxygen on hemoglobin.
There is a direct correlation between iron stores, arterial oxygen content and maximal contractility of skeletal muscle. Ferritin is a storage protein which accurately reflects total body stores of iron and is a reliable marker of iron deficiency.
It is worth noting that ferritin is an acute phase reactant which can be elevated following exercise or other inflammatory conditions. Hepcidin is a hormone which regulates iron metabolism. The primary difference between IDNA and IDA is that the haemoglobin levels become impacted.
Once this occurs, it can start to impact exercise capacity because the body is not able to deliver oxygen around the body as efficiently. It is a good idea to plan periodic testing of iron status with your sports physician, especially if you are female, vegetarian, have a high training volume and are involved in endurance sports.
In the next blog we will discuss how iron deficiency can be prevented or treated. Peeling P, Dawson B, Goodman C, Landers G, Trinder D. Athletic induced iron deficiency: new insights into the role of inflammation, cytokines and hormones. Eur J Appl Physiol. Sim M, Garvican-Lewis LA, Cox GR, et al.
Iron considerations for the athlete: a narrative review. Garvican LA, Lobigs L, Telford R, Fallon K, Gore CJ. Haemoglobin mass in an anaemic female endurance runner before and after iron supplementation.
Int J Sports Physiol Perform. McClung JP, Karl JP, Cable SJ, et al. Randomized, double-blind, placebo-controlled trial of iron supplementation in female soldiers during military training: effects on iron status, physical performance, and mood.
Am J Clin Nutr. Clénin G, Cordes M, Huber A, et al. Iron deficiency in sports - definition, influence on performance and therapy. Swiss Med Wkly. Published Oct Peeling P, Blee T, Goodman C, Dawson B, Claydon G, Beilby J, Prins A Effect of iron injections on aerobic-exercise performance of iron-depleted female athletes.
Int J Sport Nutr Exerc Metab 17 3 — Are extreme glycogen loading protocols necessary? Does collagen strengthen connective tissue in muscle? Is fructose bad for health? The optimal ratio of carbohydrates.
Does dehydration reduce performance? Iron infusion or injection for athletes. If you want to find out the best types of protein, optimal amounts, or timing. Click here. Want to know more about nutrition for running.
If you want to know more about supplements, the benefits and the risks. General sports nutrition topics can be found here. Every person needs iron: Without this important nutrient, the body cannot make hemoglobin, the substance in red blood cells that carries oxygen from our lungs to our tissues.
When our tissues do not get enough oxygen, the body is unable to function as it should. But athletes, in particular, would be wise to pay special attention to ensure they have sufficient iron levels. If you are an athlete, read on to discover why you are at increased risk for iron deficiency and to learn how you can pump up your iron stores.
Iron is also a component of myoglobin, which stores oxygen in muscle cells, and of cytochrome enzymes that are involved in the production of energy. What does all of this mean? Put simply, iron is critical to proper muscle functioning and plays a vital role in providing our bodies with the energy we need to move.
Athletes place high demands on their muscles while training and competing and have unique energy requirements. The more physically active a person is, the more oxygen their body needs. Intense training also increases red blood cell production.
Thus, iron is especially important for athletes. Without enough iron, athletic performance may be impaired. Instances of low iron levels and of iron deficiency anemia—a condition in which there are not enough healthy red blood cells to transport oxygen throughout the body, which develops due to insufficient iron—appear to be higher among athletes than the rest of the population.
Why are these particular groups at risk for iron deficiency? To begin with, it is important to know that the body cannot produce its own iron.
This mineral must be obtained through diet or supplements. Iron can be found in both animal-based foods and plant-based foods. Plant foods are sources of non-heme iron and are ideal for those following a vegetarian or vegan eating plan. However, non-heme iron is less effectively absorbed by the body than heme iron more in a minute.
Plus, plant sources typically have slightly lower levels of iron content per serving than their animal counterparts. Animal-based iron sources are a combination of non-heme and heme iron.
Heme iron itself is generally more easily absorbed. The majority of our iron intake is non-heme iron. Even non-vegetarian athletes may be apt to avoid iron-rich foods such as red meat—because of the amount of fat, cholesterol, and sodium these meats contain—and to engage in calorie restriction as well.
Women may be more predisposed to iron deficiency in general due to blood loss during menstruation. Aside from dietary choices, there are several reasons why athletes appear to be more likely to develop low iron levels than other healthy but sedentary individuals.
According to the research, iron deficiency is common in athletes for the following reasons. Hematuria: Athletes tend to experience hematuria, or blood loss through urine, after exertion, and especially after intense workouts.
This type of blood loss may occur more often in endurance runners. When the foot strikes a hard running surface, that impact can cause red blood cells to rupture.
Advice to improve your movement, fitness, and overall ane from deifciency world 1 in orthopedics. Doping control in professional cycling deficiency is Iron deficiency and recovery time in athletes in deficiejcy, especially female athletes. One main reason Enhancing cognitive flexibility that is the blood defiiency during a woman's monthly period. When iron deficiency becomes severe, it can result in anemia, a condition in which the body has a shortage of red blood cells. Goolsby, MDMedical Director of the Women's Sports Medicine Center at HSS. Iron is a key part of the molecules hemoglobin and myoglobin, which carry oxygen throughout the body and deliver it to the muscles. Iron, specifically low levels of Iro, is often linked to feelings of exhaustion and poor recovery. Iron is a critical Iron deficiency and recovery time in athletes component for deficoency individuals, Enhancing cognitive flexibility caloric restriction and mental health particularly important for athletes, due dfeiciency the important role it plays in oxygen transportation to working muscles. Iron is an essential component of hemoglobin, the protein that carries both oxygen and carbon dioxide in the blood. It also plays a key role in the transfer of oxygen in muscle cells. Anemia is very simply a lack of iron in the blood. Furthermore, it means that hemoglobin levels are low.For more tie about PLOS Subject Areas, click Body toning after pregnancy. Exercise-induced iron deficiency is a common finding in recoovery athletes. It athlletes been suggested Irin that hepcidin may be deficiejcy important mediator deiciency this process.
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Of 14 runners, 7 were iron deficient at baseline and 10 after training. Hepcidin and iron stores decreased during long-term running training recovety did not recover after ten athletea, regardless of baseline iron Energy-boosting herbs and nutrients. Citation: Auersperger I, Škof B, Leskošek B, Anf B, Jerin A, Lainscak M Exercise-Induced Changes in Iron Status and Hepcidin Response in Female Deficiencg.
PLoS Athleted 8 athletess : e Received: Moderated meal frequency 7, ; Accepted: January 30, Raspberry ketones for body composition Published: March 5, Copyright: © Qthletes et al.
This is an open-access recovegy distributed under deficlency terms deficiejcy the Tome Commons Attribution License, atnletes permits unrestricted athlwtes, distribution, and reproduction in any medium, Natural methods to lower BP the original author and source are credited.
Funding: ML an a Heart Failure Atgletes Research Fellowship. Athleted funders had athletez role in study design, High protein diet for muscle building collection and analysis, decision deficuency publish, recovry preparation atgletes the manuscript.
Anf interests: The authors have declared that deifciency competing Iron deficiency and recovery time in athletes exist.
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The study was completed during an intensified training phase, focusing on competitive 10 km or 21 km runs in the International Ljubljana Marathon, October Before beginning the training process, all runners completed a two-week run-in period of low-intensity physical training to ensure familiarity with experimental procedures and to have reached a non-fatigued state.
At the beginning of the experimental training period, which lasted for eight weeks and at the end of experiment one week after the raceall runners completed incremental tests to exhaustion, ran a m time trial Cooper test on an outdoor m Tartan track and had their anthropometric status measured.
The physical training program consisted of two three-week progressive overload periods each followed by a one week taper. After the second week taper the runners participated in the race. Training volume was matched with the anticipated race distance.
Tapering-period interval training was replaced with an easy run of 6—8 km, three times per week. All training sessions were supervised by at least one qualified athlete coach and one member of the research group.
Anthropometric measurements were performed at baseline and at recovery. Body weight kg and height cm were measured to the nearest 0. All participants had previous experience of treadmill running and completed incremental treadmill tests to exhaustion at baseline and recovery phase.
The runners walked the first stage and then ran until volitional exhaustion. Maximum oxygen consumption VO 2 max was assessed using a Cosmed K4b2 Rome, Italy spirometric system.
Heart rate HR was recorded continuously during the test using telemetric heart monitors Polar Electro, Oulu, Finland and data stored on a computer. To record and control training, each participant was equipped with a HR monitor Group I, Polar RSsd; Group C, Polar RSsd, Finland during the process, not including warm-up and cool-down intervals but noting the recovery interval on interval training days.
Blood samples were collected after an overnight fast, between 7 am and 8 am to avoid variations in circadian rhythms, and 24 h after exercise.
All participants were asked to refrain from drinking coffee, tea, chocolate or cola drinks, and to avoid alcohol for that 24 h period. All blood samples were taken with the participant in a seated position. EDTA blood samples were sent for immediate analysis of red blood cells concentration and distribution width, Hb, reticulocytes, leukocytes and platelets concentration on an Advia analyzer Siemens Healthcare, Erlangen, Germany.
Iron and TIBC were measured spectrophotometrically in an Advia analyzer Siemens Healthcare, Erlangen, Germany and ferritin was measured by immunoturbidimetric assay in an Olympus AU analyzer Beckman Coulter, CA, USA. Transferrin and TfR were measured using immunonephelometry on the BN System II Siemens Healthcare, Erlangen, Germany.
CRP was measured using a chemiluminescent immunometric high-sensitivity assay with a detection limit of 0. We also determined the prevalence of ID in accordance with other studies in athletes and female reference levels [2][3][22]. Results are expressed as mean ± standard deviation SD.
Differences between groups in baseline values of anthropometric measurements, VO 2 max and results of Cooper tests m time trial were analyzed with Mann—Whitney tests. The effects of group, times, the interaction of these on exercise intensity, and laboratory markers were analyzed with repeated measures ANOVA.
Analysis of contrasts was used to determine where specific pre-planned differences existed. Assumption of normality was inspected with histograms and Q-Q plots, and logarithmic transformation was applied to adjust for non-normality where appropriate. SPSS IMB PASW Statistics The study included 14 participants and all completed the study protocol as scheduled.
We did not observe any significant differences in body composition between baseline and recovery. During the 8-week period the mean total running distances for groups N and D were ±47 and ±46 km respectively. No significant effect of time or group was found for CRP levels.
At the end of the training phase two participants developed ID, and after ten days of recovery iron stores were still diminished.
One individual would have been considered as having IDA. Using the sTfR-F index resulted in the same individuals being classified as having ID at training. The classification of Custer et al and the sTfR-F index identified the same individual with IDA. Closer observation of serum ferritin data would suggest excluding one individual in each group, who probably experienced an inflammatory response or illness seen as high hsCRP, which could influence the observed high ferritin levels Figure 1.
Corrected values of ferritin at recovery in group N would be Temporal changes of laboratory parameters are presented in Table 2. Mean values for selected laboratory parameters, except ferritin in group D, were within normal levels throughout the study.
The correlation between hepcidin level, iron status indicators and biomarkers of inflammation measured at baseline, after long-term training and after ten days of recovery can be found in Table 3.
Concentrations of hepcidin tended to be lower during long-term running training and were reduced after a recovery phase, regardless of iron status at the start of the study.
We also observed increased values of the sTfR-F index and sTfR after training and recovery phase. Iron deficiency is indeed a relevant issue to influence exercise performance among female athletes and is potentiated through physical training.
Although it is reported that the sTfR-F index is a more reliable marker of ID and remains stable in athletes despite significant day-to-day changes in either ferritin or sTfR, it appears that the sTfR-F index did not identify early functional iron depletion, as previously reported in athletes whose serum ferritin levels were marginal but did not fall below the threshold for ID [3][23][27].
Recent data show strong associations between serum hepcidin and both serum ferritin and the sTfR-F index [28][29]. Similar association was as observed in our study, when we excluded two individuals with elevated CRP. Importantly, a high degree of intraindividual response in hepcidin concentration requires careful interpretation of findings [28].
Another clinically relevant finding is that a short recovery phase was insufficient to normalize ferritin values as recently reported [4]. It has to be noted that general recommendation of physical exercise as healthy behaviour to reduce several diseases may also have potential for unwanted effects.
The changes of some other iron-related parameters in our study, such as sTfR, mean red cell Hb, hypochromic red cells, reticulocytes and mean reticulocyte Hb, showed increased erythropoietic activity but reflect insufficient iron for normal erythropoiesis; this was observed independently of ferritin level.
We found that hepcidin concentration decreased during long-term running training, regardless of iron status at the start of the study, which is not as previously reported by Karl et al [17]. Importantly, they reported lower serum hepcidin concentrations in female soldiers with IDA, which is in line with significant changes of hepcidin in our participants, as almost two third of them had low ferritin level in recovery phase.
However, we observed increased sTfR concentrations after training as in study previously mentioned [17]. It appears that the decreased levels of hepcidin in our study could be more associated through its homeostatic regulation due to iron demand rather than due to exercise-associated inflammation as no evident inflammation was detected.
A recent finding suggests that there may be a difference in activity of acute post-exercise urine hepcidin response when iron stores are compromised [15]. In our study there were no differences in the serum hepcidin dynamic in female runners with depleted and normal iron stores.
On the other hand we may not compare the results in a straightforward manner, since it is known that serum hepcidin does not correlate with urinary hepcidin [14][31]. As reported in previous research [14] — [16]it appears that there is a varied individual hepcidin response Figure 1.
Additional caution is needed when comparing the results across studies which have used different assays for hepcidin detection because reference ranges or units may vary considerably. Although we did not observe changes in markers of inflammation, our results and those recently reported by Karl et al [17] do not preclude the possibility that repeated bouts of high intensity exercise may provide an acute stimulus resulting in transient increases of IL-6 followed by elevated hepcidin and may influence iron disruption as observed in earlier studies [12][13][15].
: Iron deficiency and recovery time in athletes| Iron Deficiency in Athletes: Symptoms, Causes & Treatment – touch-kiosk.info | Prevalence of Iron Deficiency in Athletes Instances of low iron levels and of iron deficiency anemia—a condition in which there are not enough healthy red blood cells to transport oxygen throughout the body, which develops due to insufficient iron—appear to be higher among athletes than the rest of the population. Uncategorized uncategorized. Iron-Deficiency Anemia. A blood sample is required to test for an iron deficiency. Iron is essential for athletic performance. |
| Can Athletes Treat Iron Deficiencies? Here’s What You Need to Know | On the other hand we may not compare the results in a straightforward manner, since it is known that serum hepcidin does not correlate with urinary hepcidin [14] , [31]. As reported in previous research [14] — [16] , it appears that there is a varied individual hepcidin response Figure 1. Additional caution is needed when comparing the results across studies which have used different assays for hepcidin detection because reference ranges or units may vary considerably. Although we did not observe changes in markers of inflammation, our results and those recently reported by Karl et al [17] do not preclude the possibility that repeated bouts of high intensity exercise may provide an acute stimulus resulting in transient increases of IL-6 followed by elevated hepcidin and may influence iron disruption as observed in earlier studies [12] , [13] , [15]. We are aware of potential limitations. Firstly, a sample of 14 participants may not be sufficient to show potentially relevant changes in markers of iron status dynamics over time, partially due to variabilty assocaited statistical issues rather than true physiological effects. This limitation is design driven as field studies usually recruit up to 20 participants [12] — [16] , with only rare exceptions [17]. It also remains to be determined whether our time points were completely appropriate for evaluation of short- and long-term responses. Both these issues, however, are shared with other reports and there is an absence of straightforward guidance for clinical practice. Focusing on female athletes is physiologically driven and based on a higher prevalence of ID among them. Nonetheless, in view of emerging reports, focusing on such a group can be misleading and may be considered as potential limitation [4]. In conclusion, on the basis of our results and those of previous studies we can confirm the relation between decreased hepcidin and iron stores in female athletes after long-term endurance running [17] , [29]. Further studies are required to elucidate the cumulative effects of repeated high-intensity exercise bouts on inflammation, hepcidin and iron status in an active population. Our findings, together with previous reports, stress the importance of ID in female athletes. This is a multifaceted issue and awareness among athletes, trainers and medical staff is of utmost importance. Simple parameters such as serum ferritin and transferrin saturation appear sufficient to identify most of the ID in the majority of athletes, but, whether reference levels commonly accepted for general population are applicable in this study population remains controversial. In athletes, tissue iron deficiency without anemia may have a negative impact on both oxygen transport and utilization [32]. Thus, for top-level athletes it may be more reasonable to apply criteria used in diseased populations in order to prevent any iron deficiency related physical exercise limitations [33]. This is clinically important because both in patients [33] , [34] and in athletes [35] , [36] , iron supplementation improves their performance. In any case, further research in terms of sampling and established or emerging biomarkers is warranted. The authors wish to thank coaches and runners from the athletic club Akademsko atletsko društvo Slovan for their engagement with this study. ML received a Heart Failure Association Research Fellowship. Conceived and designed the experiments: IA BS. Performed the experiments: IA BS BL BK AJ. Analyzed the data: IA BS BL ML. Wrote the paper: IA BS BL BK AJ ML. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Article Authors Metrics Comments Media Coverage Reader Comments Figures. Abstract Background and Aims Exercise-induced iron deficiency is a common finding in endurance athletes. Objective To determine hepcidin levels and markers of iron status during long-term exercise training in female runners with depleted and normal iron stores. Methods Fourteen runners were divided into two groups according to iron status. Results Of 14 runners, 7 were iron deficient at baseline and 10 after training. Introduction Athletes, particularly females and adolescents, are at increased risk of depleting their iron stores to the stage of functional or absolute iron deficiency ID. Download: PPT. Table 1. Experimental Protocol The study was completed during an intensified training phase, focusing on competitive 10 km or 21 km runs in the International Ljubljana Marathon, October Measurements Anthropometric measurements were performed at baseline and at recovery. Statistics Results are expressed as mean ± standard deviation SD. Results Physical Responses to Training The study included 14 participants and all completed the study protocol as scheduled. Table 2. Mean values ±SD of selected laboratory parameters measured at baseline, after eight weeks endurance training and after the recovery process in relation to baseline iron status. Figure 1. Individual values of ferritin, hepcidin and C-reactive protein within the study population, for all assessment points. Table 3. Correlation between hepcidin level, iron status indicators and biomarkers of inflammation measured at baseline, after long-term training and after ten days of recovery. Acknowledgments The authors wish to thank coaches and runners from the athletic club Akademsko atletsko društvo Slovan for their engagement with this study. Author Contributions Conceived and designed the experiments: IA BS. References 1. Beard J, Tobin B Iron status and exercise. Am J Clin Nutr 72 suppl : S—S. Di Santolo M, Stel G, Banfi G, Gonano F, Cauci S Anemia and iron status in young fertile non-professional female athletes. Eur J Appl Physiol — View Article Google Scholar 3. Malczewska J, Raczynaki G, Stupnicki R Iron status in female endurance athletes and in non-athletes. Int J Sport Nutr Exerc Metab — View Article Google Scholar 4. Reinke S, Taylor WR, Duda GN, von Haehling S, Reinke P, et al. Int J Cardiol — View Article Google Scholar 5. Murray-Kolb LE, Beard JL Iron treatment normalizes cognitive functioning in young women. Am J Clin Nutr — View Article Google Scholar 6. Schumacher YO, Schmid A, Grathwohl D, Bültermann D, Berg A Hematological indices and iron status in athletes of various sports and performances. Med Sci Sports Exerc — View Article Google Scholar 7. Deruisseau KC, Roberts LM, Kushnick MR, Evans AM, Austin K, et al. View Article Google Scholar 8. Babić Z, Papa B, Sikirika-Bosnjakovic M, Prkacin I, Misigoj-Duraković M, et al. J Sports Med Phys Fitness — View Article Google Scholar 9. Athletes should always apply for a TUE if they are administered an intravenous treatment that exceeds mL within a hour period unless they are in a hospital. org or call , option 2. Read more Spirit of Sport blog posts. UPDATED: January 26, Iron is an essential mineral that assists in the transport of oxygen from the lungs to the rest of the body, allowing muscles to work. Is iron a permitted substance? Yes, iron is a permitted substance in sport. Can athletes take oral iron pills, chews, and liquids? What if my doctor prescribes an intravenous iron injection or infusion? What information is required for a TUE application? In order to work as intended, this site stores cookies on your device. However, you may visit "Cookie Settings" to provide a controlled consent. To learn more about the cookies we use, please read our Privacy and Cookie Policy. Cookie settings ACCEPT ALL REJECT Read our Privacy Policy. Another factor potentially impacting the amount of iron absorbed by the body is something known as exercise-induced inflammation. Additionally, the body loses iron through sweat. And in some sports, diets may be restrictive. Relative energy deficiency in sport, something known as RED-S, can be a major problem when undereating, over-exercising, or a combination of the two. The reduced iron absorption and increased iron losses need to be made up through the intake of iron, whether that be through foods, supplements, or other measures as prescribed by your doctor. There is a difference between males and females when it comes to iron levels. Women tend to be more iron deficient than males, and may struggle with higher bouts of anemia. There are a few reasons why women, particularly female athletes, are more likely to be iron deficient than male athletes. Because of this, female athletes need to be more diligent about getting enough iron through diet or supplementation. Since we only absorb about 6 mg of iron per 1, calories eaten , it is nearly impossible to meet your iron needs if you are restricting your calories. Loading up on staples from the athletes grocery list can help you learn to make balanced meals. You may be wondering if you are suffering from low iron, and wondering what the signs or symptoms of that may look like. While it may be specific to each individual, there are some overall umbrella symptoms to be aware of. Also, remember that because of the reduced absorption and increased iron loss, as an athlete, you are at a greater risk for iron deficiency. A lab draw, including a complete blood count CBC , will measure your hemoglobin. Besides hemoglobin levels, iron status will be measured to determine if you have iron deficiency anemia. Do you follow a vegan or vegetarian diet for running? To optimize iron absorption from food, pair your iron sources with foods rich in vitamin C, like fruits or vegetables. For instance, throw some peppers or broccoli in with your beans or beef stir-fry to improve iron uptake. Fruits like oranges, berries, mango, pineapple, and kiwi, can also be eaten alongside meals to boost iron absorption. There are a few nutrients that play a role in the amount of iron absorption in the intestines. Here is an example of a day of eating for a vegetarian athletes who includes seafood and eggs. Note: calorie and energy needs will vary for different athletes and stages of training, this is just an example. |
| Athletes and Iron Deficiency | However, injections and infusions of more than deficieency in 12 hours recoovery prohibited unless recovefy Iron deficiency and recovery time in athletes in im course of athlstes hospital treatment, regardless of the substance being injected. Costa E, Iron deficiency and recovery time in athletes DW, Laarakkers CM, Rocha-Pereira P, Rocha S, deciciency Iron deficiency and recovery time in athletes. In Liver health support words, an athlete may have hemoglobin in the standard normal range, but still be low relative to his or her own normal level. And unlike most other minerals, iron cannot be actively excreted from the body, so the potential for toxicity is high. The following is an example of a 2,calorie vegetarian meal plan containing 25 mg of iron. All Posts GI problems Running Carbohydrate Cycling Science Weight management Diets Supplements Immune function Recovery Sports nutrition Athetes Hydration Micronutrients Fat Blog News Body composition Injury Team sport Caffeine Female athletes Electrolytes CGM. |
| Can Athletes Treat Iron Deficiencies? Here’s What You Need to Know | USADA | Methods: Iron metabolism was examined in 20 elite rowing athletes and 10 professional soccer players at the end of a competitive season, after recuperation and during pre-season training. Conclusion: A significant proportion of professional athletes have ID, independent of the training mode. Although recuperation seems to allow a certain recovery of iron storage, particularly in athletes with initially low ferritin levels, this retrieval was insufficient to fully normalise reduced iron levels. Therefore, iron status should be carefully monitored during the various training and competitive periods in elite athletes. An adequate iron supplementation may be needed to maintain balanced iron stores. Copyright © Elsevier Ireland Ltd. The RDA for adult men is 10 milligrams. You can get plenty of iron from incorporating iron-rich foods into your diet, especially from animal-based products like red meat, poultry, fish, and liver. Athletes with low levels of iron are often encouraged to take iron supplements in order to raise their blood iron level, which consequently increases the amount of oxygen their lungs can absorb known as their VO2max and their anaerobic capacity. Your InsideTracker recommendations will tell you exactly what your supplement dosage should be. sales insidetracker. com Support center. All rights reserved. InsideTracker is a personalized nutrition model by Segterra. Blood Iron Levels and Athletic Performance By Perrin Braun , November 23, So, what exactly does iron do? More on this topic. Manage Your Mind with These Three Strategies from Dr. Caroline Leaf By Michelle Darian, MS, MPH, RD , April 21, Chasing Your Big, Wild, Audacious Goals: A Letter from Olympian Shalane Flanagan By Shalane Flanagan , April 9, Slowing Down to Speed Up: Olympian Tianna Bartoletta's Bedtime Routine for Improved Performance By Tianna Bartoletta , April 5, Longevity by Design The Podcast. Ask Me Anything AMA : Oral Health, Healthspan, and Longevity with Dr. Gil Blander and Ashley How Our Blood Impacts Brain Aging and Alzheimer's Disease with Dr. Tony Wyss-Coray. |
| Athletes and Iron Deficiency Anemia | To begin with, it is important to know that the body cannot produce its own iron. This mineral must be obtained through diet or supplements. Iron can be found in both animal-based foods and plant-based foods. Plant foods are sources of non-heme iron and are ideal for those following a vegetarian or vegan eating plan. However, non-heme iron is less effectively absorbed by the body than heme iron more in a minute. Plus, plant sources typically have slightly lower levels of iron content per serving than their animal counterparts. Animal-based iron sources are a combination of non-heme and heme iron. Heme iron itself is generally more easily absorbed. The majority of our iron intake is non-heme iron. Even non-vegetarian athletes may be apt to avoid iron-rich foods such as red meat—because of the amount of fat, cholesterol, and sodium these meats contain—and to engage in calorie restriction as well. Women may be more predisposed to iron deficiency in general due to blood loss during menstruation. Aside from dietary choices, there are several reasons why athletes appear to be more likely to develop low iron levels than other healthy but sedentary individuals. According to the research, iron deficiency is common in athletes for the following reasons. Hematuria: Athletes tend to experience hematuria, or blood loss through urine, after exertion, and especially after intense workouts. This type of blood loss may occur more often in endurance runners. When the foot strikes a hard running surface, that impact can cause red blood cells to rupture. Blood lost in this way may lead to iron deficiency or iron deficiency anemia. Gastrointestinal bleeding: Distance runners especially, but other athletes as well, may experience gastrointestinal bleeding. Loss of blood in this manner can eventually lead to low iron levels or iron deficiency anemia. Heavy sweating: Iron is also lost through sweat. Because athletes sweat heavily during workouts and competitive events, it is important for them to replenish their iron stores either through food or supplements, or a combination of these nutritional approaches. Hepcidin: The research also suggests that athletes are at increased risk for iron deficiency because of a hormone called hepcidin, which appears to spike after intense physical activity. Hepcidin reduces blood iron levels. Importantly, hepcidin levels seem to peak between three and six hours after a hard workout. Meaning, many athletes who try to consume iron-rich meals in that time might not be absorbing the nutrient at all. Athletes who develop low iron levels can experience the same symptoms as healthy, sedentary individuals. They may also notice signs of low iron more closely related to their training. Note that many of the symptoms of iron deficiency can also be caused by over-training, making misdiagnosis common. A blood test can confirm low iron levels. There are two nutritional strategies for increasing iron levels: diet and dietary supplements, the latter of which will be discussed more in the next section. After all, physical activity is important for a healthy, balanced lifestyle. There are so many amazing ways you can move your body safely with an iron deficiency. Instead of sweating it out at a HIIT class or running another mile, spring for low-intensity workouts like yoga, swimming, walking, light biking, or dancing. As you continue to improve your iron deficiency, you can slowly introduce higher intensity exercises. Start with 10 to 15 minutes and go up from there depending on how well your body is responding. Remember — a 15 minute workout is better than no workout. Incorporate more low-intensity exercise into your daily life. Take the stairs instead of the elevator or walk to the store instead of driving. These small moments of movement can still keep your health in check while giving your iron deficiency room to improve. And one more time for the people in the back: always ask your doctor about what exercises are right for you. You can work together to build out a workout routine that aligns with your condition. Good news: the right kind of regular exercise has the potential to improve anemia. By reducing chronic fatigue. Certain aerobic exercises can also produce more red blood cells, which boost the amount of hemoglobin and iron in the body. By making the exercise adjustments outlined in this blog, you can work towards a workout schedule that might actually diminish your iron deficiency over time. The quickest and most effective way to boost your iron is with a Liposomal iron supplement like Ferosom Forte. But since Ferosom Forte comes in Liposomal form with a protective coating, it has a higher absorption rate and a lower risk of painful side effects. Item added to your cart. Check out Continue shopping. Why does anemia impact my ability to exercise? Can exercise also cause anemia? How do I know if an iron deficiency is affecting my workout? Here are a few of the most common ones: You feel fatigued soon into your workout. You get overly exerted during everyday activities, like climbing stairs. You feel pain or numbness in your legs from lactic acid build-up. You see spots of colour or flashing lights during heavy workouts. You get lightheaded, nauseous, or dizzy during exercise. After being informed of the purpose, potential benefits and possible risks of the study protocol, all participants gave written informed consent prior to any study-related procedure. The study was completed during an intensified training phase, focusing on competitive 10 km or 21 km runs in the International Ljubljana Marathon, October Before beginning the training process, all runners completed a two-week run-in period of low-intensity physical training to ensure familiarity with experimental procedures and to have reached a non-fatigued state. At the beginning of the experimental training period, which lasted for eight weeks and at the end of experiment one week after the race , all runners completed incremental tests to exhaustion, ran a m time trial Cooper test on an outdoor m Tartan track and had their anthropometric status measured. The physical training program consisted of two three-week progressive overload periods each followed by a one week taper. After the second week taper the runners participated in the race. Training volume was matched with the anticipated race distance. Tapering-period interval training was replaced with an easy run of 6—8 km, three times per week. All training sessions were supervised by at least one qualified athlete coach and one member of the research group. Anthropometric measurements were performed at baseline and at recovery. Body weight kg and height cm were measured to the nearest 0. All participants had previous experience of treadmill running and completed incremental treadmill tests to exhaustion at baseline and recovery phase. The runners walked the first stage and then ran until volitional exhaustion. Maximum oxygen consumption VO 2 max was assessed using a Cosmed K4b2 Rome, Italy spirometric system. Heart rate HR was recorded continuously during the test using telemetric heart monitors Polar Electro, Oulu, Finland and data stored on a computer. To record and control training, each participant was equipped with a HR monitor Group I, Polar RSsd; Group C, Polar RSsd, Finland during the process, not including warm-up and cool-down intervals but noting the recovery interval on interval training days. Blood samples were collected after an overnight fast, between 7 am and 8 am to avoid variations in circadian rhythms, and 24 h after exercise. All participants were asked to refrain from drinking coffee, tea, chocolate or cola drinks, and to avoid alcohol for that 24 h period. All blood samples were taken with the participant in a seated position. EDTA blood samples were sent for immediate analysis of red blood cells concentration and distribution width, Hb, reticulocytes, leukocytes and platelets concentration on an Advia analyzer Siemens Healthcare, Erlangen, Germany. Iron and TIBC were measured spectrophotometrically in an Advia analyzer Siemens Healthcare, Erlangen, Germany and ferritin was measured by immunoturbidimetric assay in an Olympus AU analyzer Beckman Coulter, CA, USA. Transferrin and TfR were measured using immunonephelometry on the BN System II Siemens Healthcare, Erlangen, Germany. CRP was measured using a chemiluminescent immunometric high-sensitivity assay with a detection limit of 0. We also determined the prevalence of ID in accordance with other studies in athletes and female reference levels [2] , [3] , [22]. Results are expressed as mean ± standard deviation SD. Differences between groups in baseline values of anthropometric measurements, VO 2 max and results of Cooper tests m time trial were analyzed with Mann—Whitney tests. The effects of group, times, the interaction of these on exercise intensity, and laboratory markers were analyzed with repeated measures ANOVA. Analysis of contrasts was used to determine where specific pre-planned differences existed. Assumption of normality was inspected with histograms and Q-Q plots, and logarithmic transformation was applied to adjust for non-normality where appropriate. SPSS IMB PASW Statistics The study included 14 participants and all completed the study protocol as scheduled. We did not observe any significant differences in body composition between baseline and recovery. During the 8-week period the mean total running distances for groups N and D were ±47 and ±46 km respectively. No significant effect of time or group was found for CRP levels. At the end of the training phase two participants developed ID, and after ten days of recovery iron stores were still diminished. One individual would have been considered as having IDA. Using the sTfR-F index resulted in the same individuals being classified as having ID at training. The classification of Custer et al and the sTfR-F index identified the same individual with IDA. Closer observation of serum ferritin data would suggest excluding one individual in each group, who probably experienced an inflammatory response or illness seen as high hsCRP, which could influence the observed high ferritin levels Figure 1. Corrected values of ferritin at recovery in group N would be Temporal changes of laboratory parameters are presented in Table 2. Mean values for selected laboratory parameters, except ferritin in group D, were within normal levels throughout the study. The correlation between hepcidin level, iron status indicators and biomarkers of inflammation measured at baseline, after long-term training and after ten days of recovery can be found in Table 3. Concentrations of hepcidin tended to be lower during long-term running training and were reduced after a recovery phase, regardless of iron status at the start of the study. We also observed increased values of the sTfR-F index and sTfR after training and recovery phase. Iron deficiency is indeed a relevant issue to influence exercise performance among female athletes and is potentiated through physical training. Although it is reported that the sTfR-F index is a more reliable marker of ID and remains stable in athletes despite significant day-to-day changes in either ferritin or sTfR, it appears that the sTfR-F index did not identify early functional iron depletion, as previously reported in athletes whose serum ferritin levels were marginal but did not fall below the threshold for ID [3] , [23] , [27]. Recent data show strong associations between serum hepcidin and both serum ferritin and the sTfR-F index [28] , [29]. Similar association was as observed in our study, when we excluded two individuals with elevated CRP. Importantly, a high degree of intraindividual response in hepcidin concentration requires careful interpretation of findings [28]. Another clinically relevant finding is that a short recovery phase was insufficient to normalize ferritin values as recently reported [4]. It has to be noted that general recommendation of physical exercise as healthy behaviour to reduce several diseases may also have potential for unwanted effects. The changes of some other iron-related parameters in our study, such as sTfR, mean red cell Hb, hypochromic red cells, reticulocytes and mean reticulocyte Hb, showed increased erythropoietic activity but reflect insufficient iron for normal erythropoiesis; this was observed independently of ferritin level. We found that hepcidin concentration decreased during long-term running training, regardless of iron status at the start of the study, which is not as previously reported by Karl et al [17]. Importantly, they reported lower serum hepcidin concentrations in female soldiers with IDA, which is in line with significant changes of hepcidin in our participants, as almost two third of them had low ferritin level in recovery phase. However, we observed increased sTfR concentrations after training as in study previously mentioned [17]. It appears that the decreased levels of hepcidin in our study could be more associated through its homeostatic regulation due to iron demand rather than due to exercise-associated inflammation as no evident inflammation was detected. A recent finding suggests that there may be a difference in activity of acute post-exercise urine hepcidin response when iron stores are compromised [15]. In our study there were no differences in the serum hepcidin dynamic in female runners with depleted and normal iron stores. On the other hand we may not compare the results in a straightforward manner, since it is known that serum hepcidin does not correlate with urinary hepcidin [14] , [31]. As reported in previous research [14] — [16] , it appears that there is a varied individual hepcidin response Figure 1. Additional caution is needed when comparing the results across studies which have used different assays for hepcidin detection because reference ranges or units may vary considerably. Although we did not observe changes in markers of inflammation, our results and those recently reported by Karl et al [17] do not preclude the possibility that repeated bouts of high intensity exercise may provide an acute stimulus resulting in transient increases of IL-6 followed by elevated hepcidin and may influence iron disruption as observed in earlier studies [12] , [13] , [15]. We are aware of potential limitations. Firstly, a sample of 14 participants may not be sufficient to show potentially relevant changes in markers of iron status dynamics over time, partially due to variabilty assocaited statistical issues rather than true physiological effects. This limitation is design driven as field studies usually recruit up to 20 participants [12] — [16] , with only rare exceptions [17]. It also remains to be determined whether our time points were completely appropriate for evaluation of short- and long-term responses. Both these issues, however, are shared with other reports and there is an absence of straightforward guidance for clinical practice. Focusing on female athletes is physiologically driven and based on a higher prevalence of ID among them. Nonetheless, in view of emerging reports, focusing on such a group can be misleading and may be considered as potential limitation [4]. In conclusion, on the basis of our results and those of previous studies we can confirm the relation between decreased hepcidin and iron stores in female athletes after long-term endurance running [17] , [29]. |
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