Intravenous Iron Helpful for Athletes
Kelly Parcell, ND
Iron helps form hemoglobin, the part of the red blood cell that carries oxygen and thus plays an important role in the body’s delivery and use of oxygen to and by working muscles. A lack of iron in the body can reduce aerobic capacity and impair endurance performance. What remains unclear is the extent to which iron depletion without anemia and iron supplementation above basic needs affect athletic performance. Studies of the nutritional status of athletes in various disciplines have shown females are at greater risk of mineral deficiencies. This reflects the situation in the general population, with menstruating women being the main risk group for mild iron deficiency. Athletes who move from lower altitudes to higher altitudes may experience difficulty increasing their red blood cell mass and not be able to gain the benefits of altitude training their iron levels are suboptimal.
“I believe there are sufficient arguments to support controlled iron supplementation in all athletes with blood ferritin levels below 60” says Steve Parcell, ND co-owner of NatureMed in Boulder, CO. Ferritin is a storage form of iron and the most sensitive marker of iron reserves. This iron “reserve” is not tapped into until circulating levels of iron become too low to support demands. For example, if the body is using (via exercise) and excreting (via sweat, menstrual cycle) more iron than it is receiving the ferritin level will slowly decline.
This condition is known as sports anemia. The ferritin levels can be low, while the levels of hemoglobin remain within the normal range. An athlete whose ferritin level is below 60 mg/L may not be optimizing his/her potential to perform. Sports anemia is seen in endurance athletes, particularly long distance runners. The causes for this are foot strike hemolysis (red blood cell breakdown), poor dietary habits, increased iron loss in sweat and malabsorption from the intestine.
Oral iron is the conventional treatment. However, oral iron causes constipation, may fuel intestinal bacterial overgrowth and just does not work fast enough for most people.
This is where intravenous iron comes in. Intravenous iron may help athletic performance and recovery for athletes low in iron stores. We have seen a number of cases in our Boulder clinic where athletes presented with fatigue, shortness of breath and poor recovery from training. In many of these cases, though full blown iron deficiency anemia had not yet manifested, iron stores were below normal or suboptimal. When given intravenous iron the majority of these athletes reported better exercise tolerance and recovery. Some even got their careers back.
NatureMed has programs for athletes of all ages. They conduct comprehensive exercise performance physicals which include body composition, extensive blood work (including hormones) and nutritional analysis. According to Parcell, “Intravenous iron coupled with supplemental oxygen can be very helpful for increasing power and speed”