Iron Deficiency in Athletes: A Guide for Athletes

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Iron deficiency in athletes is a common issue, particularly in youth and adolescent populations and especially female athletes. 

Having an iron deficiency can impact your performance and overall well being. 

In this post, we’ll explore what iron deficiency is, how it affects athletes and what can be done to prevent and treat it.

Iron Deficiency in Athletes

What is iron deficiency

Iron deficiency occurs when the body doesn’t have enough iron to produce hemoglobin, the protein in red blood cells that carries oxygen throughout the body. 

This can lead to a variety of symptoms, including fatigue, weakness, pale skin, shortness of breath, dizziness and decreased athletic performance.

Signs and symptoms of iron deficiency

Common signs and symptoms of iron deficiency include:

  • Weakness
  • Pale skin
  • Headache
  • Tiredness
  • Shortness of breath
  • Dizziness
  • Strange cravings for non-food items (such as dirt or ice)
  • Cold hands and feet
  • Fast or irregular heartbeat
  • Brittle nails

Indicators of low iron levels in athletes

Athletes may experience symptoms such as fatigue, weakness and decreased athletic performance when their iron levels are low. (1) In addition to these symptoms, there are several tests that medical providers can use to diagnose iron deficiency. 

These include measuring levels of ferritin (a protein that stores iron) and transferrin saturation (a measure of how much iron is bound to transferrin, a protein that transports iron).

How does iron deficiency affect athletes

Athletes are at an increased risk for iron deficiency due to the demands of training and competition. 

Iron is lost through sweat, and intense exercise can also cause damage to red blood cells, leading to increased iron needs. In addition, female athletes may lose iron through menstruation. (2)

Iron deficiency can have a significant impact on athletic performance. Low iron levels can decrease endurance, reduce muscle strength, impair cognitive function and increase the risk of injury. (3)

This can make it difficult for athletes to perform at their best.

Identifying athletes at risk for iron deficiency

Iron deficiency can affect athletes across various sports , but certain factors increase the risk. By understanding these risk factors, you can take proactive steps to prevent iron deficiency and optimize your athletic performance.

High training loads and intense exercise

Intensive training places significant demands on your body, including increased iron use. 

Endurance athletes in activities, such as long-distance running or cycling, or those engaging in frequent and intense training sessions are at a higher risk of iron deficiency. 

The repeated impact and high energy expenditure can lead to increased iron losses through sweat, urine and gastrointestinal bleeding.

Inadequate iron intake

Insufficient iron intake is a common cause of iron deficiency. Athletes who follow restrictive diets, such as vegetarian or vegan diets, may find it challenging to meet their iron needs solely through plant-based sources. 

Additionally, athletes who consume a diet lacking variety or fail to prioritize iron-rich foods are more susceptible to iron deficiency.

Rapid growth and development

Youth and adolescent athletes experience rapid growth and development, which increases your iron requirements. 

Your body needs more iron during this time to support the growth of muscles, red blood cells, and other tissues. When you can’t meet these increased iron needs, this results in iron deficiency and impact athletic performance.

Female athletes

Female athletes, in particular, face an increased risk of iron deficiency due to additional factors such as menstruation. Menstruation leads to monthly blood loss, causing a significant iron loss if not adequately compensated. 

Female athletes who experience heavy or prolonged menstrual bleeding are especially vulnerable and should pay close attention to their iron status.

Previous history of iron deficiency

Athletes who have previously experienced iron deficiency are more likely to encounter it again. It is essential to monitor iron levels regularly and take appropriate measures to prevent its recurrence.

Gastrointestinal disorders or conditions

Certain gastrointestinal disorders or conditions can impair iron absorption and utilization. Conditions like celiac disease can compromise iron absorption and increase the risk of deficiency.

Preventing and treating iron deficiency in athletes

The good news is that iron deficiency can be prevented and treated. One of the best ways to ensure adequate iron intake is through a balanced diet that includes iron rich foods such as red meat, poultry, fish, beans, lentils and fortified cereals.

In some cases, an iron supplement may be necessary. It’s important to work with a healthcare provider like a registered sports dietitian nutritionist to determine the appropriate dose and form of iron supplementation.

For more information on iron for athletes and iron rich foods.


In conclusion, iron deficiency is a common issue among youth and adolescent athletes. 

Understanding the factors that put athletes at risk for iron deficiency is crucial for early detection and prevention. 

By addressing these risk factors through appropriate dietary choices, monitoring iron status, and seeking guidance from a registered dietitian, you can minimize the risk of iron deficiency and optimize your athletic performance.

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