Oct 25, 2016
On the Same Level

Iron deficiency is a common hurdle for many elite runners. While it has long been thought that female athletes are more prone to having low levels of iron because of menstruation, a new study shows that it may not be such a gendered issue. 

The investigation was conducted by a team of researchers from the University of Guelph in Ontario, Canada, and published online in the Clinical Journal of Sports Medicine on September 5. The results showed that male elite runners also struggle with maintaining healthy iron levels, and the men in the study were found to be at a higher risk of iron-deficiency anemia and low hemoglobin than the women. These findings come as a surprise to the sports medicine community, as they challenge the common understanding of iron deficiency in elite runners.

“Iron deficiency and iron-deficiency anemia is not just a woman’s issue,” lead researcher and current University of Guelph master’s student Alexandra Coates, CSEP-CPT, HFFC CEP, told Reuters Health.

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The data used in the study was derived from blood tests taken from 2009 to 2015 for 38 elite runners and triathletes. Participants reported their use of iron supplements—they took an average of 94 milligrams (mg) of iron per day—and provided blood samples every other month.

After reviewing the athletes’ blood, Coates and her team determined at least one episode of iron deficiency occurred in 60 percent of female triathletes, 38 percent of male triathletes, 56 percent of female runners, and 31 percent of male runners. The researchers noted that iron-deficiency prevalence in endurance athletes typically ranges from 20 to 50 percent for females and 0 to 17 percent for males.

The study also recorded iron-deficiency anemia occurring in 25 percent of male triathletes, 20 percent of female triathletes, 6 percent of male runners, and none of the female runners. Hemoglobin levels below 140 grams per liter (g/L)—the cutoff for anemia in men—showed up at least once in 88 percent of male triathletes and 31 percent of male runners. Levels below 120 g/L—the cutoff for women—occurred in 20 percent of female triathletes and none of the female runners.

Now that these findings have shown both male and female endurance athletes struggle with low iron levels, one of the next steps for sports medicine professionals is to determine the best methods for supplementing depleted iron. Iron infusions are a go-to solution for many athletes, but Coates says research has shown large injections of iron increase hepcidin levels, which interferes with iron absorption. Instead, she suggests looking into low-dose methods.

“We don’t have a study yet showing whether [they work]—it’s kind of a new theory,” she explained. “Obviously, the 100 mg a day isn’t working … Trying low-dose iron is worth a shot.”

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