The Athlete’s Guide to Understanding Iron Deficiency

All around the world, athletes are plagued with this issue of iron deficiency.   When I played school athletics, I’ve seen it, especially with girls in high school.  With an athlete abroad I’m working with, deficiency seems to be a problem she’s dealing with, and I’m sure it’s no stranger to you in one capacity or another (you found yourself here after all).  So for you athletes, coaches, and/or parents, I’m going to give you a quick guide to understanding iron deficiency and ways to prevent it.  Plenty of sources at the end for further reading.

Iron and its Function

Well let’s take it back, way back…to high school chemistry, which we all loved.  QOTD, what is iron?  Iron is a metal, and is the most common element in the Earth’s core.  Iron reacts easily with water and oxygen, hence why iron rusts so easily.  It is also a mineral that is important to the human body.  Hmm why is this metal good for the body, can you go sprinkle iron powder on your fries?  Umm I wouldn’t recommend that, not at all.  Iron is found in trace (small) amounts in the human body.  The average person that has enough bodily iron, has about 4-5grams of iron stored.  It has two very important purposes for the body:

  • It is a part of the hemoglobin molecule that binds to oxygen (so it’s like your blood is rust, but not really). The red blood cell ejects most of its organelles to be able to hold a lot of hemoglobin for more oxygen to be delivered.  Without it, the ability to deliver oxygen would decrease significantly as not much oxygen dissolves in the blood (as in not in a RBC) and well you wouldn’t last very long.  Hemoglobin also takes carbon dioxide out of the cell, although CO2 doesn’t bind to the iron.
  • It is apart of the cytochromes in the electron transport chain for oxidative phosphorylation…what?! It is used in the mitchondria (energy engines) in muscles (and other cells) that help with aerobic respiration, so for running 5 kilometers.  You need it to chase around young children in the park all day basically.

In short, iron is very important to the body’s ability to be active, physically and mentally.  It is a limiting factor in one’s work capacity to get through a full day of activities.


Iron Deficiency

So now that we know what iron is and what it does, let’s figure out what iron deficiency is shall we.  Oh wait, did I give it away?  It’s when your body is lacking enough iron, aka deficient.  Better put, it is the “depletion of bodily stores [of iron] and anemia, leading to decreased functional capacity of tissues.”  Iron deficiency happens in 3 stages:

  • Iron store depletion – this is when the iron stores in bone marrow, liver, and the spleen all decrease.
  • Iron deficient erythropoiesis – ability to create red blood cells (erythropoiesis) decreases as the supply in bone marrow decreases.
  • Iron deficient anemia – production of hemoglobin decreases, which is when most are actually aware of symptoms. Globally, this is thought to account for about 50% of anemia.

We’ve seen how deficiency develops once it starts, but how do people actually become deficient?

  • Loss of blood (injury, menstruation, pregnancy)
  • Not meeting body’s needs dietary-wise (growing adolescent, premenopausal women)
  • In some cases, participants of extreme endurance events (>42km runs, 9-12hr triathlons)

Given now that we know what iron deficiency is, let’s look at some symptoms of iron deficiency to be able help discern if it’s a potential problem for you or your athlete.  It’s important to note that these symptoms may be a part of other problems, they are said to likely not appear until one is already anemic, and to consult a doctor if you feel this may be a problem.  Symptoms include but are not limited to:

  • Fatigue and weakness
  • Decreased ability to maintain body temperature
  • Decreased athletic and academic performance
  • Decreased immune function
  • Swollen, inflamed tongue

As an athlete, performance at practice will decline as well as competition performance.  Females are much more likely to be anemic due to menstruation, especially young teenagers who are just beginning to menstruate and do not increase dietary iron intake.  In the U.S., 2% of males and up to 16% of women are deficient.  In many parts of Africa and South Asia, prevalence is as high as 57% for South Asian women and 40% for African males.  Iron deficiency is the top malnutrition issue in the world affecting millions of people.


If you feel you or your athlete may be short on iron life, be sure to go see a doctor so that she/he can help find out for certain.  They may put you on an iron supplement, although it is much safer to go by your doctor’s recommendation as taking too much can cause toxic problems.  In regards to preventing having low iron in the first place, it is important to eat.  It is important to take in the appropriate amount of food daily.  This chart shows the recommended daily amount in the US.

Recommended Dietary Allowance (RDA) for iron by age and sex.
Age/Group Life Stage Iron (mg/day)
Infants 0–6 months 0.27*
7–12 months 11
Children 1–3 years 7
4–8 years 10
Males 9–13 years 8
14–18 years 11
19–30 years 8
31–50 years 8
51–70 years 8
>70 years 8
Females 9–13 years 8
14–18 years 15
19–30 years 18
31–50 years 18
51–70 years 8
>70 years 8
Pregnant Women 14–18 years 27
19–30 years 27
31–50 years 27
Lactating Women 14–18 years 10
19–30 years 9
31–50 years 9


It is important to take in a diet that contains iron-rich foods to obtain this.  These foods include:

  • Lean red meat
  • Fortified cereals
  • Many types of beans (soybeans, lima beans, kidney beans, and many more)
  • Dark leafy vegetables such as spinach

It is also important to take in non-heme (non-meat) sources with Vitamin C to help with absorption.  Just to name a few of many:

  • Kiwi
  • Oranges
  • Red and green bell peppers
  • Grapefruit


As you see, iron is a very important mineral to the body as it is very important for helping delivery oxygen to the body cells and with helping the energy production system of the body.  Be sure to have a balanced diet with iron-rich foods to prevent deficiency as many symptoms aren’t noticeable until stage 3 which is anemia.  I hope this information was helpful, there are a number of weblinks and research journal articles below where this information came from and contain a plethora of information.  Share any comments or stories dealing with iron deficiency below!  If you have any questions or need further information don’t hesitate to contact me.


And remember… as iron sharpens iron, so does one red blood cell sharpen another red blood cell.





Andrews, N. C. (n.d.). Disorders of Iron Metabolism. The New England Journal of Medicine.

Dolins, S. R. (2005). Micronutrient requirements of physically active women: what can we learn from iron? The American Journal of Clinical Nutrition.

GIOVANNI LOMBARDI, G. L. (2014). Iron Requirements and Iron Status of Athletes. In I. O. Committee, Sports Nutrition (p. Chapter 19).

Iron and Iron Deficiency. (2011). Retrieved from CDC Centers for Disease Control and Prevention:

NGUYEN, S. L. (2014). Vitamins, Minerals, and Sport Performance. In I. O. Committee, Sports Nutrition.

RJ, S. (2003). Iron deficiency: global prevalence and consequences. Food and Nutrition Bulletin.

Staff, M. C. (2014). Iron Deficiency Anemia. Retrieved from Mayo Clinic:


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