Which Athlete is at Highest Risk For Iron Deficiency?

Which Athlete is at Highest Risk For Iron Deficiency?

Written by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.

Iron plays a vital role in oxygen transport to the body's muscles and organs. It's also essential for brain function and the immune system.

Low iron levels can lead to a variety of symptoms. They include fatigue, chronic muscle pain, reduced stamina, irritability and decreased appetite.

Symptoms of an Iron Deficiency

You might have symptoms of an iron deficiency if you don't eat enough foods that contain iron, your body can't properly absorb iron (such as in celiac disease), or you lose iron through your blood (such as from an injury, heavy menstrual periods, or bleeding inside your intestines). Women who are pregnant or breast-feeding also need extra iron to help their growing baby.

A doctor can tell if you have an iron deficiency by checking your iron level and other tests. Your doctor might order blood tests to check your hemoglobin levels and other blood counts, like your platelet count.

Hemoglobin is a protein that carries oxygen throughout your body, so low hemoglobin levels can cause you to feel tired or listless. In extreme cases, you might have shortness of breath because the fewer red blood cells in your blood mean less oxygen is being carried.

Your doctor may order a bone marrow aspiration or biopsy to look for a lack of iron in your marrow. The procedure involves taking a small amount of fluid or solid bone marrow tissue to examine for the number and size of blood cells and abnormal blood cells.

Depending on the cause of your iron deficiency, your doctor may recommend taking oral supplements or a multivitamin containing iron. These can help you create an iron "store" and restore your iron levels. However, it is essential to find out the underlying cause of your iron deficiency before you take any treatment so that your body can heal itself.

Why Are Female Athletes at Risk of Iron Deficiency?

Women athletes are often at higher risk of iron deficiency and anemia than non-athletes. This is mainly because of the monthly loss of blood during menstruation and heightened exercise-induced iron losses.

Iron is an essential nutrient and is needed to transport oxygen in the body. It is also important for muscle function and energy production, particularly during intense physical activity such as athletics. Without enough iron, the body cannot produce and use red blood cells or deliver oxygen to the muscles effectively.

The human body has a limited capacity to store iron, so it needs to get it from the diet. The main sources of dietary iron are found in heme (from animal meats and seafood) and non-heme (from plants).

Heme iron is more easily absorbed than non-heme. This is why consuming foods rich in heme iron such as meat, poultry and fish will help improve iron levels. Other sources of heme iron include fortified cereals and dark green leafy vegetables, such as spinach, broccoli and kale.

Athletes are at greater risk of iron deficiency because they require more oxygen during training and competition, which requires a larger number of red blood cells. Those with lower iron levels may feel more fatigued and unable to train at their peak level.

Female athletes can increase their iron intake by modifying their diets and improving meal composition to optimize the absorption of iron. They should aim to consume a wide variety of foods to ensure they are getting the right balance of protein, carbohydrate and iron from their diets.

They should also avoid eating food that inhibits iron absorption such as tea, coffee and chocolate. They should also try to eat foods that are high in vitamin C, such as citrus fruits and strawberries, which help the absorption of iron.

These dietary modifications can be implemented by the athlete themselves in conjunction with their nutritionist. 

Alternatively, an athlete can take oral iron supplements to increase their iron intake and/or to maintain their iron status.

Athletes should be aware of the symptoms of an iron deficiency and be sure to get regular testing and treatment. They should also be sure to eat a nutritious diet, especially before and during exercise to boost their iron levels.

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Why are vegan athletes at risk of an iron deficiency?

Plant foods contain iron in a form that is less bioavailable than iron from meat or fish, so it is important to ensure you consume enough to meet your needs. High fiber foods like bran can inhibit iron absorption, and certain plant chemicals, called phytates, can also inhibit it.

Athletes should make sure they are getting enough iron through their diets and take a supplement to improve iron absorption if needed. Another important mineral for athletes is zinc, which is also found in plants and is vital for growth, protein synthesis, enzymatic reactions, and healing wounds.

In addition to iron, vegan athletes may need to take a multivitamin to get all the nutrients they need for optimal athletic performance. They should also consider taking iodized salt, which is necessary for healthy thyroid function. Creatine, an amino acid that is commonly used to improve performance, and taurine are other supplements that vegan athletes can take.

Does Training at Altitude Increase the Risk of an Iron Deficiency?

During high-altitude training or living, athletes stimulate erythropoiesis, which results in the production of red blood cells (RBCs) and hemoglobin (Hb), the protein that transports oxygen from the lungs to the rest of the body. As a result, athletes need more iron to support the increased production of these essential components.

Athletes may be susceptible to an iron deficiency, which can lead to fatigue, shortness of breath, and impaired recovery from training or exercise. Ideally, athletes should be tested before any altitude training to determine their current iron status. 

When a deficiency is diagnosed, the athlete should start taking an iron supplement. A physician will recommend the appropriate iron dosage based on their assessment of ferritin and other iron markers. It is important to remember that an increase in the dosage of an iron supplement can have negative health effects, so it’s always best to start with a small amount and gradually build up to a higher dosage as needed.

One possible reason for a deficiency is that an athlete’s blood volume may be decreased, which can make it more difficult to take in enough iron through the diet alone. Hence, athletes who are planning to train at high altitudes should plan to increase their intake of iron and drink lots of water to help replenish the lost fluids from their body.

It is also important to consume a sufficient amount of carbohydrates during an altitude training camp as this will help fuel the increased production of haemoglobin. It is estimated that a trained endurance athlete can gain up to 10% of their normal haemoglobin mass during a 3-week altitude training session.

In addition, athletes should avoid any iron-containing foods and drinks during their training at high altitudes as these can contain toxic levels of heme iron, which can cause a number of health problems. For example, excessive amounts of heme iron can impair the liver’s ability to metabolize iron, which can have long-term consequences for an athlete’s health and performance.

Lastly, it is recommended that an athlete consume ample antioxidant-rich foods during their altitude training as they can reduce oxidative stress. This is especially true at low-moderate altitudes, where oxidative stress is more prevalent.

There is not much research on the impact of nutrition and/or supplements on optimizing altitude adaptations to low-moderate altitudes in elite athletes. In contrast, the nutritional impacts of mountaineering training at altitudes above 3000 m have been extensively studied. These studies have provided a detailed description of the changes in energy, carbohydrate and fluid utilization, as well as specific nutrient requirements.

Despite the considerable evidence highlighting the need for enhanced iron consumption during altitude training, there are no clear guidelines as to the most effective dose of iron that can optimize an athlete’s HBmass response to hypoxic training. 

1. Soccer Players

Soccer players play a sport that involves a lot of fast movement, and they need to be strong and powerful. These athletes also need to be able to perform well in a variety of different positions, and they need to know how to work with their teammates to win games.

They must also be able to maintain control and focus in a stressful situation, as well as have stamina while playing a long game or tournament. These skills and more are vital to being a successful soccer player, and they can be developed and improved over time.

Athletes who are involved in endurance sports are at a higher risk of iron deficiency. This is because the increase in plasma volume during endurance training can dilute red blood cells, making hemoglobin and hematocrit appear low on test results.

However, athletes who are not involved in endurance sports can still be at risk of iron deficiency. These athletes should have their iron levels tested before they begin a new season or a few weeks into a training program.

They should also consume a healthy diet rich in protein, carbohydrate, and fat to support their athletic performance. They should aim to eat between 1.2 and 1.7 grams of protein per kilogram of body weight daily, and they should be sure to eat enough carbohydrates to fuel their workouts. They should also drink a sufficient amount of water to stay hydrated during their training sessions and competitions.

2. Tennis Players

Athletes who play aerobic sports (such as tennis, rowing, handball and some swimming and track and field events) are at the highest risk for iron deficiency. The main reason for this is that they are more likely to exhaust iron stores in a shorter period of time when performing these sports than athletes who do not.

Symptoms of iron deficiency include fatigue, weakness, dizziness, and lightheadedness when exercising. The condition can also cause headaches and mood deterioration.

Iron deficiency can be detected through blood tests examining hemoglobin and serum ferritin. Having low levels of either one of these is considered an indication that iron is depleted in the body, and that you need to get more iron into your diet.

In this case, you should consult a doctor or an accredited sports dietitian to develop an appropriate iron supplement plan. You can also eat foods rich in iron such as a lean cut of beef or pork three or four times a week. In addition, make sure to eat vitamin C-rich foods with your iron-rich meals to enhance absorption.

3. Baseball Players

Athletes are at a higher risk for iron deficiency than non-athletes because they lose so much iron through sweat, urine, and gastrointestinal tract bleeding (for example, runners often have blood in their stool after races). Female athletes are also at a greater risk because they menstruate and can use up their iron reserves.

In addition, athletes may not get enough iron if they have certain chronic medical conditions or bone marrow disorders. Additionally, older adults may have low iron levels because of age-related iron deficiency.

The condition can progress to anemia if it isn't addressed. This condition can be a serious concern for athletes because it decreases aerobic capacity and causes loss of energy.

When an athlete is diagnosed with iron deficiency, he or she should be treated with supplemental iron to replete his or her iron stores. Taking iron supplements along with a healthy, balanced diet can restore hematocrit and hemoglobin within a few weeks. However, it can take up to 12 months for a fully repleted iron store to be achieved.

Athletes who experience symptoms of iron deficiency should be referred to their physician for a complete blood count (CBC). The lab will evaluate hemoglobin, hematocrit, and ferritin. They will also look for other signs and symptoms of iron deficiency, including fatigue that worsens with exercise.

4. Football Players

Iron is an important mineral that plays a key role in the transport of oxygen throughout the body. It is also important for energy metabolism and acid-base balance.

People can develop iron deficiency because they don't get enough iron from food or they have conditions that make it hard for their bodies to absorb it. Gender, age, lifestyle, family history and two inherited diseases called hemophilia and von Willebrand disease are all factors that may increase an athlete's risk for developing iron deficiency.

Female athletes are at particular risk for developing iron deficiency because they lose blood every month during menstruation, which reduces their overall intake of dietary iron. They should take extra care to ensure they have sufficient dietary iron, especially if they are following a vegetarian diet or eating low-protein foods.

Athletes who are at risk for iron deficiency should consult with their doctor about getting blood tested to determine if they have an iron deficiency or not. If the test reveals that they do, they should be given a supplement that will provide them with adequate levels of iron.

Iron deficiency can go undetected for a long time because symptoms usually appear only when hemoglobin is low, which is at a certain stage of the condition called early functional iron deficiency without anemia. At this point, an athlete has less capacity to deliver oxygen to the muscles and performance suffers.

5. Basketball Players

During exercise, the body uses iron to make red blood cells. Without enough iron, it may not be able to transport oxygen to the muscles, causing fatigue and decreased performance.

There are several factors that can contribute to an athlete’s risk for iron deficiency or anemia. These include age, gender, dietary habits and training level.

One of the most important aspects of a healthy diet is getting sufficient iron from foods that are high in vitamin C, as this can help your body absorb non-heme iron more effectively. Other good sources of iron are organic chicken, fish, eggs, beans, vegetables, and whole grains.

The symptoms of iron deficiency can be difficult to diagnose, so it’s important to get a blood test done. A doctor can check for low iron levels and also check for other health problems that might be related to a lack of iron.

Female athletes, especially those who bleed heavily during menstruation, are at the highest risk for iron deficiency or anemia. This is due to the fact that they usually consume less iron overall than male athletes do.

Athletes who have increased their iron intake or are starting to train harder should be tested for iron deficiency. They should also be monitored for signs of iron deficiency, such as increased fatigue and decreased performance. They should also be told to avoid eating foods that reduce the absorption of iron, such as tea and coffee, as well as phytates found in certain grain products.

Nutrient recommendations

In addition to consuming plenty of fruits, vegetables, whole grains, and lean proteins, athletes should meet their daily recommended intakes for vitamins, minerals, and micronutrients. A diet rich in these nutrients can improve performance, prevent injury, and support overall health.


A well-balanced diet can provide athletes with the carbohydrates they need to fuel intense training and competition. Good sources of carbohydrates include whole grains, legumes, and fruit.


A high-protein diet is essential for athletes, as it helps repair and build muscle tissue. Protein-rich foods include lean meats, fish, eggs, and dairy products.


Athletes should eat enough healthy fats to support their energy needs and keep their blood sugar levels stable. Good sources of healthy fats include nuts, seeds, avocado, and fatty fish.

In addition to a balanced diet, athletes should drink plenty of water throughout the day and during exercise. This is important because dehydration can lead to decreased cognitive function and impaired athletic performance. All people should drink at least 8-10 cups of fluid per day. They should also drink additional fluids during exercise to replace the fluid they lose through sweat. You can calculate this through your sweat rate.


Athletes - especially females, adolescents, vegetarians and those with poor eating habits or following an energy restricted diet - are at a higher risk for iron deficiency. This is due to the body's ability to absorb dietary iron at lower levels than in non-athletes.

Dietary Iron Intake: Athletes need a high intake of dietary iron to replenish their bodies' stores and meet their oxygen needs. This includes heme (animal) and non-heme (plant) iron from foods such as lean meat, poultry, fish, wholegrains and fortified cereals.

Hemoglobin and Oxygen Transport: Without adequate amounts of iron, your blood may not carry sufficient oxygen to the muscle cells. This can affect your training, endurance and recovery.

Symptoms of Iron Deficiency

Athletes experiencing any symptoms of low blood iron should seek immediate medical attention. These include fatigue and a reduced ability to perform tasks.

Women who experience heavy menstrual bleeding are also at a greater risk for iron deficiency. This may be because the body's ability to absorb dietary sources of iron is lower in women.

Hematuria, or blood loss through the urine, is also common in athletes as well as gastrointestinal bleeding which can lead to low iron levels and iron deficiency anemia.

Fortunately, iron deficiencies can be resolved with simple dietary modifications and by taking iron supplements. These can be administered orally and in liquid forms. It's important to consult with a sports dietitian to determine the best method for you.

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