Endurance athletes (such as cyclist's, triathletes and marathon runners) possibly need more iron than most people, due to accelerated destruction of red blood cells, muscle injuries, loss of iron through sweat, and over-training with insufficient time to reabsorb iron.
Dedicated Athlete always recomends that you get your blood checked and reviewed by a certified physician or Doctor, before consuming any iron supplements.
Here are some abstract referrences from various sports and sources.
Endurance swimming, intravascular hemolysis, anemia, and iron depletion. New perspective on athlete's anemia.
Swimmers were evaluated for the anemia, intravascular hemolysis, and iron deficiency reported in endurance runners. Plasma concentrations of ferritin, haptoglobin, and hemoglobin were measured in nine collegiate swimmers through the competitive season and in 23 adult swimmers before and after endurance races of 1.5 km to 10 km. About 10 percent of the swimmers had low hemoglobin concentrations. The severity of this "swimmer's anemia" correlated with the amount of swimming in both men and women. Intravascular hemolysis occurred during all the races; the fastest swimmers in the longest races had the greatest decreases in haptoglobin. About 25 percent of the swimmers had low baseline haptoglobin concentrations. Iron depletion was found in 11 percent of the men and 57 percent of the women, but their athletic performance was not notably impaired. Iron depletion, anemia, and intravascular hemolysis in athletes in a nontraumatic sport suggest that mechanisms other than footstrike are components of athlete's hemolysis.
Reduced hemoglobin concentration and red cell moglobinization in Italian marathon and ultramarathon runners.
Red blood cell indices, serum iron, and serum ferritin concentration were determined in 45 marathon runners, 56 ultramarathon runners, and 32 healthy sedentary controls. A significant reduction of hemoglobin concentration, hematocrit, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular volume, serum iron, and serum ferritin were found in marathon runners compared to control subjects. The same variables were also reduced, but to a lesser extent, in the less trained ultramarathon runners. The decreased hemoglobin concentration demonstrated in the runners examined is related to both a reduced mean corpuscular hemoglobin concentration and a reduced hematocrit and may depend on a reduction of the body iron stores.
Effects of ultra-marathon training and racing on hematologic parameters and serum ferritin levels in well-trained athletes.
Hematologic parameters and serum ferritin levels were measured in groups of experienced ultra-marathon runners under control conditions, 2 days after a 160-km ultra-marathon, and for up to 14 days after a 56-km ultra-marathon. Under resting conditions, 14% of the runners had subnormal serum ferritin levels compared to 2% of a control group and not one of a group of trained swimmers. Serum ferritin levels that were markedly elevated after both ultra-marathon races returned to pre-race levels only 6 days after the 56-km ultra-marathon and continued to fall in athletes who did not exercise for a further 8 days. Other hematologic changes that were present after either of the ultra-marathon races included: immediate post-race hemoconcentration (shown by increased mean red cell count, hemoglobin level, and packed cell volume) and increased mean corpuscular volume, followed by hemodilution that was greatest 48 h after the 160-km race; an increased mean corpuscular hemoglobin concentration and reticulocyte production index; transient leukocytosis, monocytosis, lymphocytopenia, eosinophilopenia, and the appearance of band cells. With the exception of the increase reticulocyte production index and the reduced packed cell volume, all other hematologic parameters had returned to control levels 6 days after the 56-km race. This study shows that serum ferritin levels may be subnormal in a proportion of distance runners and that daily training and ultra-marathon racing in particular may cause these levels to remain elevated for between 6--14 days. Thus, when hematologic parameters are measured in distance runners, it should be remembered that recent prolonged exercise may (1) produce a "dilutional anemia," (2) by increasing serum ferritin levels, mask a true iron deficiency, and (3) that these changes may require up to 6 days to return to normal.
Red blood cell profile of elite olympic distance triathletes. A three-year follow-up.
Nutrition and Toxicology Research Institute Maastricht, Department of Movement Sciences, Maastricht University, Maastricht, The Netherlands. Gerard.Rietjens@bw.unimaas.nl
The purpose of this study was to monitor general and individual changes in hematological variables during long-term endurance training, detraining and altitude training in elite Olympic distance triathletes. Over a period of three years, a total of 102 blood samples were collected in eleven (7-male and 4 female) elite Olympic distance triathletes (mean +/- SD; age = 26.4 +/- 5.1 yr; VO(2) max = 67.9 +/- 6.6 ml/min/kg) for determination of hemoglobin (Hb), hematocrit (Hct), red blood cell count (RBC), Mean corpuscular hemoglobin (MCH), Mean corpuscular hemoglobin content (MCHC), Mean corpuscular volume (MCV) and plasma ferritin. The data were pooled and divided into three periods; off-season, training season and race season. Blood samples obtained before and after altitude training were analyzed separately. Of all measured variables only RBC showed a significant decrease (p < 0.05) during the race season compared to the training season. Hematological values below the lower limit of the normal range were found in 46 % of the athletes during the off-season. This percentage increased from 55 % during the training season to 72 % of the athletes during the race season. Hemoglobin and ferritin values were most frequently below the normal range. There was a weak correlation between Hb levels and VO(2) max obtained during maximal cycling (r = 0.084) and running (r = 0.137) tests. Unlike training at 1500 m and 1850 m, training at an altitude of 2600 m for three weeks showed significant increases in Hb (+ 10 %; p < 0.05), Hct (+ 11 %; p < 0.05) and MCV (+ 5 %; p < 0.05). Long-term endurance training does not largely alter hematological status. However, regular screening of hematological variables is desirable as many athletes have values near or below the lower limit of the normal range. The data obtained from altitude training suggest that a minimum altitude (>2000 m) is necessary to alter hematological status.
Gastrointestinal blood loss in triathletes: it's etiology and relationship to sports anaemia.
Latchford Barracks Medical Centre, Bonegilla, Victoria.
Twenty male triathletes (R 18-39 mean = 27.5 yrs) provided blood and faecal samples during intense training, pre-race taper and post-competition. All answered a closed-end questionnaire on intake of aspirin, NSAIDS, Vitamin C, iron and red meat. History of GIT blood loss and training distances were also obtained. Blood samples were taken on three occasions and analysed for Haemoglobin(Hb) and Serum Ferritin concentrations. Faecal specimens were collected on five occasions and assessed for blood loss using Haemoccult II and Monohaem (a monoclonal antibody test specific for human haemoglobin). Mean Hb and 95% confidence intervals at the three stages were 14.53gm/l (13.95-15.10), 14.9gm/l (14.46-15.34), 14.57gm/l (14.18-14.97) respectively. There was a small, but statistically significant, increase in Hb during the pre-race taper period (paired t = 2.65, p < 0.05), and a non-significant drop in Hb post-event (paired t = 1.89, p = 0.075). Mean ferritin, MCV and haematocrit values did not significantly change. Eighty percent of the group exhibited faecal blood loss on one or more of the tests used. There were significant increases in both Haemoccult (chi 2 = 5.44, p < 0.04) and Monohaem (chi 2 = 7.36 p < 0.02). Regression analysis demonstrated a significant relationship between training Hb and total training intensity (R = -0.61, F1,l5 = 8.98, p < 0.009) and training run intensity (R = -0.55, F1,l5 = 6.17, p < 0.026), as estimated using Coopers aerobic points system. These results confirm that GIT blood loss is common in endurance athletes, and appears to be related to exercise intensity. The possible mechanisms of blood loss are discussed.
Dietary iron deficiency and sports anaemia.
Department of Haematology, University of Cape Town Medical School, South Africa.
In order to determine whether dietary inadequacies can explain the sub-optimal iron status widely documented in endurance-trained athletes, the food intake records of Fe-deficient and Fe-replete distance runners and non-exercising controls of both sexes were analysed. In all the male study groups the mean dietary Fe intake met the recommended dietary allowances (RDA; > 10 mg/d (US) Food and Nutrition Board, 1989). However, both female athletes and controls failed to meet the RDA with regard to Fe (< 15 mg/d) and folate (< 200 micrograms/d). There was no difference in the total Fe intakes of Fe-deficient and Fe-replete athletes and the controls of each sex. However, Fe-deficient male runners, but not female runners, consumed significantly less haem-Fe (P = 0.048) than their comparative groups. This suggests that the habitual consumption of Fe-poor diets is a factor in the aetiology of athletes' Fe deficiency.
Influence of dietary iron source on measures of iron status among female runners.
Human Performance Laboratory, Ball State University, Muncie, IN 47306.
The purpose of the present investigation was to determine whether female runners who consume a modified vegetarian diet are predisposed to iron deficiency. Two groups of female runners who were matched for age, weight, aerobic capacity, miles run per week, and number of pregnancies were obtained for this study. One group (N = 9) regularly consumed a modified vegetarian diet (MV, less than 100 g red meat.wk-1), while the other group (N = 9) consumed a diet which included red meat (RM). Serum ferritin values were significantly (P less than 0.05) lower for the MV group (X +/- SE, 7.4 +/- 1.4 ng.100 ml-1) than for the RM group (19.8 +/- 4.2 ng.100 ml-1). Total iron binding capacity (TIBC) of the serum was also significantly different between the two groups of subjects (MV, 366.5 +/- 12.2 micrograms.100 ml-1; RM, 327.2 +/- 9.6 micrograms.100 ml-1). While dietary iron intake was comparable for the two groups (MV, 14.7 +/- 2.0 mg.d-1; RM, 14.0 +/- 2.2 mg.d-1, the bioavailability of the dietary iron was significantly different (MV, 0.66 +/- 0.08 mg.d-1; RM, 0.91 +/- 0.10 mg.d-1). As the presence of heme iron (from meat, fish, and poultry) increases the bioavailability of dietary iron, the results of the present investigation suggest that vegetarian athletes have altered iron status due to the form in which their dietary iron is consumed.
Increased blood viscosity in iron-depleted elite athletes.
Service d'Exploration Physiologique des Hormones et des Metabolismes, CHRU de Montpellier, France.
Since iron deficiency is associated with abnormal erythrocyte rheology, we investigated relationships between plasma ferritin and blood rheology in 36 male elite sportsmen (age: 22.38+/-0.9 years). On the whole, ferritin was negatively correlated with blood viscosity (r = -0.36, p < 0.05). When 23 subjects with low ferritin levels suggesting mild iron deficiency were compared with 13 matched sportsmen with normal ferritin levels, iron-deficient sportsmen were shown to have a higher blood viscosity at 1000 s(-l) (3.17+/-0.09 vs. 2.85+/-0.06 mPas, p < 0.05), explained by a higher plasma viscosity (1.38+/-0.02 vs. 1.31+/-0.02 mPa s, p < 0.05), while hematocrit and RBC rigidity index Tk were similar in the two groups. RBC aggregability index M (4.59+/-0.58 vs. 2.95+/-0.43 mPas, p < 0.05) and M1 (8.46+/-0.58 vs. 6.07+/-0.55, p < 0.01) were higher in iron-deficient subjects. Serum zinc was lower in iron-deficient sportsmen (0.73+/-0.02 vs. 0.83+/-0.02 mg/l, p < 0.01), but the score of early signs of overtraining was higher in this group (10.84+/-1.61 vs. 4.08+/-1.11, p < 0.01). These data suggest that mild iron deficiency as commonly seen in athletes, before anemia occurs, is associated with an increase in plasma viscosity and RBC aggregation, together with an increased subjective feeling of exercise overload.
Sports anemia, iron supplements, and blood doping.
Medicine & Science in Sports & Exercise. 24(9) Supplement:315-318, 1992.
EICHNER, E. RANDY
Abstract:
EICHNER, E. R. Sports anemia, iron supplementation, and blood doping. Med. Sci. Sports Exerc., Vol. 24, No. 9 Supplement, pp. S315-S318, 1992. Key Points: 1) Athletes tend to have lower hemoglobin concentrations than sedentary counterparts. This has been called sports anemia, a misnomer. 2) Sports anemia is a false anemia and a beneficial adaptation to aerobic exercise, caused by an expanded plasma volume that dilutes red blood cells. 3) Athletes, however, can also develop true anemia, most commonly caused by iron deficiency. True anemia curbs athletic performance, but nonanemic iron deficiency does not. 4) Iron supplements are useful for women endurance athletes who repeatedly develop iron deficiency anemia despite dietary advice. 5) Some endurance athletes today are blood doing by abusing recombinant human erythropoietin (rEPO). They risk dying to win
An audit of clinically relevant abnormal laboratory parameters investigating athletes with persistent symptoms of fatigue.
Greenslopes Centre for Sport and Movement, Queensland, Australia.
The purpose of this study was to assess the yield of a selection of laboratory tests as part of the clinical assessment of the fatigued athlete. This was done with retrospective analysis of clinical charts and blood test results at a private sports medicine clinic, Brisbane, Australia. Fifty consecutive athletes who presented with the primary complaint of fatigue had haematology, biochemistry and serology tests at the same laboratory. The main outcome measurements were haematology (haemoglobin, red cell count, mean cell volume, mean cell haemoglobin content, platelets, white cell count, differential white cell count); erythrocyte sedimentation rate; serum biochemistry (urea, creatinine, electrolytes, urate, glucose, liver function tests, albumin, globulin); blood iron status (serum iron, total iron binding capacity, percent transferring saturation, and ferritin concentration); thyroid stimulating hormone; and immune measures (Epstein-Barr virus serology, cytomegalovirus serology). We found that only three abnormal results contributed to the diagnosis of medical disease as a cause for fatigue. Laboratory testing identified two fatigued female athletes with serum ferritin concentration between 15mugL(-1) and 20mugL(-1) plus two of the other criteria of iron concentration (serum iron <10mumolL(-1), iron binding capacity >68mumolL(-1), or transferrin saturation <15%). The yield from a selection of blood tests investigating fatigued athletes was low. Future study is needed to further define the role of laboratory testing and to study whether low iron stores in the absence of anaemia is related to symptoms in fatigued athletes.
Utility of hematological and iron-related screening in elite athletes.
Department of Sports Medicine, Australian Institute of Sport, Belconnen ACT.
OBJECTIVE: To determine the clinical and performance related utility of hematological and iron-related screening in elite athletes. DESIGN: Prospective cohort study. SETTING: The Department of Sports Medicine at the Australian Institute of Sport. PARTICIPANTS: Male and female elite athletes undergoing routine medical screening over a period of 2 to 3 years. INTERVENTION: Blood testing for hematological and iron-related biochemical variables. MEASURES: White blood cell count, red blood cell count, hemoglobin, hematocrit, mean cell volume, mean cell hemoglobin concentration, platelet count, percent hypochromic red cells, serum iron, ferritin, transferrin, and percent transferrin saturation. RESULTS: Eight female athletes (4.6%) had clinically relevant abnormal results, 6 with an obvious explanation on clinical history and examination and 1 who was diagnosed with hemochromatosis following genetic testing. Eighty-nine (51.1%) female athletes had abnormal results that were not associated with obvious clinical signs or symptoms. Twenty-seven female athletes had a serum ferritin less than 30 ng/mL and were placed on iron supplementation. In male athletes, 5 cases had screening abnormalities that were associated with illness or other factors identified during the clinical consultations. Nonclinically significant abnormalities in males were generally minor reductions in hemoglobin and/or hematocrit or minor alterations in red cell parameters. Five male athletes had a serum ferritin less than 30 ng/mL and were placed on iron supplementation. CONCLUSION: Screening for hematological and iron-related abnormalities in male athletes has a very low yield. Due to the critical nature of the effects of anemia and low serum ferritin on some aspects of performance, it is reasonable to perform a full blood count and a serum ferritin on male athletes entering an elite training program. Further testing should be performed on clinical grounds. In females, the yield is greater. Again, it is reasonable to perform a full blood count and a serum ferritin on female athletes entering an elite training program. In view of their greater risk of iron depletion and to assess the effect of increased training inherent in elite programs, this could be repeated at 6-month intervals, or an isolated measurement of serum ferritin could be performed. Further testing should be performed on clinical grounds.
Serum haptoglobin and ferritin during a competitive running and swimming season.
Department of Health Promotion and Human Performance, The University of Toledo, Ohio, USA.
The purpose of the study was to examine ferritin, haptoglobin, and red cell indices during a competitive running and swimming season. Male runners (N = 8) and swimmers (N = 5) were tested four times during their respective seasons. The runners were tested before the start of organized practice (RT1), after 3 wk of increased training (RT2), 3 wk prior to the conference championship (pre-taper, RT3), and 3 d after the conference championship (post-taper, RT4). The swimmers were tested after the first 9 wk of training (ST1), after completing 2 wk of hard training (ST2), after an additional 6wk of training (pre-taper, ST3), and 1 wk following the conference championship (post-taper, ST4). For the runners, hemoglobin, hematocrit, and red blood cell number were lower (p < 0.05) at RT2 and were not accompanied by significant changes in other red cell indices or haptoglobin. Serum ferritin in the runners was lower at RT3 and RT4 compared to RT1 despite an adequate dietary iron intake. Hemoglobin and mean cell hemoglobin concentration were lower and mean cell volume was higher in the swimmers at ST3 and ST4. No significant changes were observed in other red cell indices for swimmers; however, serum haptoglobin tended (p = 0.07) to be reduced at ST2. In conclusion, collegiate male runners and swimmers do not demonstrate clinical hypoferritinemia, hypohaptoglobinemia, or alterations in red cell indices suggestive of the early stage of anemia with or without iron deficiency during their respective season.
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