title: Iron deficiency in sports - definition, influence on performance and therapy.
abstract: Iron deficiency is frequent among athletes. All types of iron deficiency may affect physical performance and should be treated. The main mechanisms by which sport leads to iron deficiency are increased iron demand, elevated iron loss and blockage of iron absorption due to hepcidin bursts. As a baseline set of blood tests, haemoglobin, haematocrit, mean cellular volume, mean cellular haemoglobin and serum ferritin levels help monitor iron deficiency. In healthy male and female athletes >15 years, ferritin values <15 mcg are equivalent to empty, values from 15 to 30 mcg/l to low iron stores. Therefore a cut-off of 30 mcg/l is appropriate. For children aged from 6-12 years and younger adolescents from 12-15 years, cut-offs of 15 and 20 mcg/l, respectively, are recommended. As an exception in adult elite sports, a ferritin value of 50 mcg/l should be attained in athletes prior to altitude training, as iron demands in these situations are increased. Treatment of iron deficiency consists of nutritional counselling, oral iron supplementation or, in specific cases, by intravenous injection. Athletes with repeatedly low ferritin values benefit from intermittent oral substitution. It is important to follow up the athletes on an individual basis, repeating the baseline blood tests listed above twice a year. A long-term daily oral iron intake or i.v. supplementation in the presence of normal or even high ferritin values does not make sense and may be harmful.
authors.affiliation: Sportmedizinisches Zentrum Ittigen bei Bern, Haus des Sports, Ittigen, Switzerland.
authors.forename: German
authors.initials: G
authors.lastname: Clénin
authors.affiliation: Sportmedizinisches Zentrum Ittigen bei Bern, Haus des Sports, Ittigen, Switzerland.
authors.forename: Mareike
authors.initials: M
authors.lastname: Cordes
authors.affiliation: Zentrum für Labormedizin, Kantonsspital Aarau, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Huber
authors.affiliation: Aspetar Orthopedic and Sports Medicine Hospital, Doha, Quatar.
authors.forename: Yorck Olaf
authors.initials: YO
authors.lastname: Schumacher
authors.affiliation: Zentrum für Medizin und Sport im Säntispark, Abtwil, Switzerland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Noack
authors.affiliation: Bannockburn Health Centre, Stirling, Scotland.
authors.forename: John
authors.initials: J
authors.lastname: Scales
authors.affiliation: Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Switzerland.
authors.forename: Susi
authors.initials: S
authors.lastname: Kriemler
mesh_terms: D000293:Adolescent; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000503:physiopathology*; D056352:Athletes; D054874:Athletic Performance / Q000502:physiology*; D002648:Child; D019587:Dietary Supplements; D005260:Female; D005293:Ferritins / Q000097:blood; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000378:metabolism; D019266:Iron, Dietary / Q000627:therapeutic use*; D008297:Male; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D019266:Iron, Dietary; D005293:Ferritins; D007501:Iron