Anemia in Athletes: Enhancing Performance with Screening
- Curtis Baker
- 10 minutes ago
- 2 min read
Training makes you stronger, but it can quietly drain the mineral iron that red blood cells need to carry oxygen. Up to 68% of elite dancers, for example, have low ferritin (iron marker) despite careful diets (Jack 2023). Iron is important because it is needed to make new red blood cells. Here’s why iron slips away during sport and what you can do about it.
1 Bigger Blood, “Thinner” Counts
A month of regular running, cycling, or swimming adds extra water (plasma) to your blood. That dilutes red-blood-cell counts and produces a “sports anemia” on lab reports (Bärtsch 1998). Your body then has to build more red cells, and every new cell needs iron.
2 Running Can Burst Red Cells
Each foot strike sends shock through tiny vessels in your feet and can break older red blood cells. A treadmill study showed four times more broken cells after one hour of running than after cycling at the same effort (Telford 2003). Replacing those cells quickly uses up stored iron.
3 Sweat and Urine Leak Iron
Sweat isn’t just water and salt—it carries iron too. Climate-chamber tests found athletes can lose 1–2 mg of iron in a two-hour hot workout, roughly 10 % of a teens daily need (Saran 2018). Hard sessions may also cause tiny, invisible blood leaks in urine, adding to the drain.
4 Hepcidin: The Post-Workout “Closed Door”
After tough intervals or games, your liver releases the hormone hepcidin. For about three to six hours, hepcidin shuts the gut “door” that lets iron enter your bloodstream, cutting absorption roughly in half (Peeling 2023). Taking iron with breakfast before practice or late in the evening helps dodge this blockade.
5 Periods Add a Monthly Iron Debt
While this is more general - anyone with a period loses extra iron each cycle. This make iron deficiency even more common in female athletes in particular. A survey of young female athletes found iron deficiency almost three times higher than in non-athletes their age, even though they ate similar foods (Łusakowska 2021).
6 Real-World Numbers Across Sports
7 Red Flags to Watch For
Getting winded at speeds that used to feel easy
Higher resting or practice heart rate
Pale skin, cold hands and feet, or restless legs at night
Brain fog or more colds during heavy training blocks
Bottom Line
Low iron in athletes isn’t usually one big leak—it’s many small ones: diluted blood, smashed red cells, sweaty workouts, blocked absorption, and, for many women, monthly periods. Protect your iron, and every practice will pay off with more power, endurance, and quicker recovery. Our clinic can run full iron panels, design meal plans, and track your progress all season long—keeping both your iron, red blood cell counts, and your finish times on target.
