title: Four weeks of IV iron supplementation reduces perceived fatigue and mood disturbance in distance runners.
abstract: OBJECTIVE
  To determine the effect of intravenous iron supplementation on performance, fatigue and overall mood in runners without clinical iron deficiency.
  
  
  METHODS
  Fourteen distance runners with serum ferritin 30-100 µg · L(-1) were randomly assigned to receive three blinded injections of intravenous ferric-carboxymaltose (2 ml, 100 mg, IRON) or normal saline (PLACEBO) over four weeks (weeks 0, 2, 4). Athletes performed a 3,000 m time trial and 10 × 400 m monitored training session on consecutive days at week 0 and again following each injection. Hemoglobin mass (Hbmass) was assessed via carbon monoxide rebreathing at weeks 0 and 6. Fatigue and mood were determined bi-weekly until week 6 via Total Fatigue Score (TFS) and Total Mood Disturbance (TMD) using the Brief Fatigue Inventory and Brunel Mood Scale. Data were analyzed using magnitude-based inferences, based on the unequal variances t-statistic and Cohen's Effect sizes (ES).
  
  
  RESULTS
  Serum ferritin increased in IRON only (Week 0: 62.8 ± 21.9, Week 4: 128.1 ± 46.6 µg · L(-1); p = 0.002) and remained elevated two weeks after the final injection (127.0 ± 66.3 µg · L(-1), p = 0.01), without significant changes in Hbmass. Supplementation had a moderate effect on TMD of IRON (ES -0.77) with scores at week 6 lower than PLACEBO (ES -1.58, p = 0.02). Similarly, at week 6, TFS was significantly improved in IRON vs. PLACEBO (ES -1.54, p = 0.05). There were no significant improvements in 3,000 m time in either group (Week 0 vs. Week 4; Iron: 625.6 ± 55.5 s vs. 625.4 ± 52.7 s; PLACEBO: 624.8 ± 47.2 s vs. 639.1 ± 59.7 s); but IRON reduced their average time for the 10 × 400 m training session at week 2 (Week 0: 78.0 ± 6.6 s, Week 2: 77.2 ± 6.3; ES-0.20, p = 0.004).
  
  
  CONCLUSIONS
  During 6 weeks of training, intravenous iron supplementation improved perceived fatigue and mood of trained athletes with no clinical iron deficiency, without concurrent improvements in oxygen transport capacity or performance.
authors.affiliation: University of Canberra, Research Institute for Sport and Exercise, Canberra, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Woods
authors.affiliation: University of Canberra, Research Institute for Sport and Exercise, Canberra, Australia; Australian Institute of Sport, Canberra, Australia.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Garvican-Lewis
authors.affiliation: Australian Institute of Sport, Canberra, Australia.
authors.forename: Philo U
authors.initials: PU
authors.lastname: Saunders
authors.affiliation: Australian Institute of Sport, Canberra, Australia.
authors.forename: Greg
authors.initials: G
authors.lastname: Lovell
authors.affiliation: Australian Institute of Sport, Canberra, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Hughes
authors.affiliation: Australian Institute of Sport, Canberra, Australia.
authors.forename: Ruth
authors.initials: R
authors.lastname: Fazakerley
authors.affiliation: Australian Institute of Sport, Canberra, Australia.
authors.forename: Bev
authors.initials: B
authors.lastname: Anderson
authors.affiliation: Australian Institute of Sport, Canberra, Australia.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Gore
authors.affiliation: University of Canberra, Research Institute for Sport and Exercise, Canberra, Australia.
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D000328:Adult; D005221:Fatigue / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005290:Ferric Compounds / Q000494:pharmacology / Q000627:therapeutic use*; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008320:Maltose / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D019964:Mood Disorders / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D012420:Running / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005290:Ferric Compounds; D006454:Hemoglobins; C522335:ferric carboxymaltose; D008320:Maltose; D005293:Ferritins