Introduction Iron Deficiency (ID) is a spectrum of disease common in athletes, especially among females and those that participate in endurance sports.
Iron Deficiency (ID) is a spectrum of disease common in athletes, especially among females and those that participate in endurance sports. There are two forms of ID: iron deficiency non anemia (IDNA), defined by decreased iron stores, and iron deficiency anemia (IDA), which is defined by a drop in iron stores and hemoglobin. Generally speaking, this is due to iron losses exceeding iron intake and absorption.
Early on in the disease, athletes will have ID with normal hemoglobin levels, while in later or more severe phases of the disease they will develop IDA. Case Question A 23 year old female track athlete at a division 1 university presents with increasing fatigue and decreasing performance over the last few months of training. She is a vegan but has met with a dietician who told her she was consuming enough calories.
There have been no changes in her training program. She has no history of stress fractures and has a normal body habitus. Her point of care glucose is normal.
Which of the following is the most likely diagnosis? A) Iron Deficiency Anemia B) Overtraining Syndrome C) Diabetes Mellitus D) Relative Energy Deficiency in Sport Iron Deficiency Anemia Iron deficiency is fairly common among athletes, ranging from 15-35% among females and 3-11% among males. IDA is far less common, seen in 0-2% of all athletes but has been reported as high as 15% among female athletes.
It is important to consider other causes of fatigue, malaise and decreased exercise performance. Examples would include relative energy deficiency in sport, female athlete triad, hypothyroidism, diabetes, overtraining syndrome, sleep dysfunction and depression among many others. Iron is a critical component of heme formation, the protein chain responsible for carrying oxygen on hemoglobin.
If you are experiencing symptoms that may be related to iron deficiency anemia in athletes, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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