Iron deficiency: what it is and how to avoid it
Not to be confused with anaemia, iron deficiency can be a debilitating condition for the active triathlete if not properly treated. Here's everything you need to know about its causes, symptoms and management…
Iron is a key dietary mineral that helps to form the red blood cells that transport oxygen to your muscles. So if you’re not getting enough in your body, your ability to perform well in training and racing will start to decrease.
While you should be able to get all the iron you need from your diet, see below, the body, annoyingly, doesn’t absorb iron particularly well and it can be diminished further through training.
How much iron should you consume per day?
According to the NHS, the amount of iron you need is:
- 8.7mg a day for men over 18.
- 14.8mg a day for women aged 19 to 50.
- 8.7mg a day for women over 50.
What is iron deficiency?
First of all, let’s clear up the common misconception that iron deficiency equals anaemia – this isn’t the case. Anaemia is a more severe form of iron deficiency, and can be caused by a lack of other vitamins or a symptom of other medical issues.
Iron deficiency without anaemia (IDWA) occurs when ferritin (a protein in the blood that contains iron levels) levels fall below 30µg/l. It’s possible to feel symptoms even with normal Hb (hemoglobin levels) and not meet the criteria for anaemia.
How can you test for iron deficiency?
A simple blood test at your GP to check your ferritin levels will determine whether you’re deficient. From there you can discuss the results and treatment plan with your doctor. They may still suggest iron supplementation if you aren’t anaemic, should your ferritin levels be below 30µg/l.
What are the signs and symptoms of iron deficiency?
The symptoms, with or without anaemia, can include:
- Fatigue
- Headaches
- Dizziness
- Brain fog
- Heavy periods
- Hair loss/thinning
- Restless leg syndrome
- Heart palpitations
- Shortness of breath
- Pale skin
Are women more likely to be iron deficient?
Women are more susceptible to iron deficiency due to blood loss during menstruation, with those who have heavy periods or short cycle lengths at the highest risk.
Others at risk also include vegans, vegetarians, and those who restrict nutrient intake during phases of dieting.
- The best sources of protein for vegan and vegetarian triathletes
- Vegan meal ideas: what can vegans eat?
How can iron deficiency affect training and racing triathlon?
Low iron levels can affect athletic performance and recovery in many ways. Iron is a key component in haemoglobin and myoglobin, the molecules which carry oxygen around the body in the red blood cells to the muscles.
Low iron levels can therefore result in reduced transportation of oxygen around the body and result in fatigue, which impacts the ability to push hard in both training and racing.
Iron is also responsible for energy production at a cellular level and is vital for cognitive and immune function.
Are athletes more at risk of being iron deficient?
Athletes are at a greater risk than the general population because the inflammatory response post-exercise can reduce the body’s ability to absorb iron. Sweating and gastrointestinal bleeding is another reason why athletes are at an increased risk.
Of course, fatigue can be caused by many other factors, such as overtraining and under-recovery (poor nutrition, sleep, hydration), but athletes would be wise to get a blood test.
How can I treat iron deficiency?
If diagnosed with iron deficiency you may be offered iron supplements or sometimes and injection by your GP, or you may be advised to make dietary changes.
Which foods are rich in iron?
But not all iron is created equally, for example heme iron is found in animal and fish sources and is more bioavailable/readily absorbed and utilised by the body.
Non-heme iron is found in plant sources – beans, pulses, wholegrains and dark leafy greens – and isn’t as easily absorbed, so larger amounts are required for the same benefit. Bread, cereal and pasta are useful as they’re often fortified with iron.
Vitamin C can help promote the absorption of iron within the body when consumed at the same time, so drinking a glass of orange juice with supplements/food is advised. Conversely, drinking caffeinated beverages can inhibit the absorption of iron, so having these with a meal should be avoided.
- What are the most important nutrients endurance athletes need in their diet?
- Eating protein throughout the day reduces muscle loss in older people
Top image: Getty Images
Jesse Lambert-Harden
Nutrition coach, personal trainer and biomechanics trainer 
