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Iron Deficiencies in Women Runners

A good friend, and extremely talented fellow runner wrote to me recently. Her training has been progressing slowly, and she has been struggling with injuries. Her doctor has told her that her iron stores are low, especially the serum ferritin. This led me to wonder how common this is in women runners.

Iron deficiency is widely reported in women athletes. Numerous articles state the causes, concerns and solutions for iron deficient athletes. Iron deficient women, due to their greater iron needs and generally lower calorie intake, face a lifelong "iron crisis." (Health Fitness) A women should consume 15 -18 milligrams of iron daily. Decreased consumption of red meat and low calorie intake explain why female athletes have difficulty meeting the RDA of 15 mg of iron. Surveys of female athletes show mean daily energy intakes ranging from 1,706 to 3,572 kcal, with an average of 13 mg/d of iron. (Sports Medicine Source)

That is why poor iron status is more common in women exercisers / athletes - especially distance runners - than in their male counterparts.

Suzanne Eberle, author of Endurance Sports Nutrition, discusses the difficulity of consuming enough iron in a meatless world. She states that even minimal deficiencies can hamper performance. Iron forms hemoglobin and myoglobin, which carry oxygen to the blood and muscles. Less iron means less red blood cells, which means less oxygen, which means less energy. Also, iron helps to combat the increased breakdown of red blood cells due to exercise. Females are at a special risk because of smaller reserves and losses through menstruation.

The best source of absorbable iron is in meat. About 20 to 30 percent of the iron in meat is absorbed, while only 2 to 8 percent of the iron in plants can be absorbed. Incidently, heme iron (the iron in meat) is found not only in red meat, but in poultry (especially the dark meat), fish and seafood. Dairy foods and eggs are not good sources, however. Vitamin C can be added to enhance the absorption of iron. Plant sources which provide iron include dark leafy greens, tomato and prune juice, dried fruit, legumes, lentils, soy foods, whole grains and wheat germ.

If you are deficient, it is not recommended to go overboard on supplements. Additional supplements may be necessary, but it is important to monitor your iron levels using blood tests which look at your hemoglobin, hematocrit, and serum ferritin (the storage form of iron) levels. Too much iron can interfer with the absorbtion of zinc and coppper, and can cause constipation, as well as a deficiency in other minerals.

In Runner's World Complete Guide to Running by Dagny Scott, she describes the symptoms of deficiency as exteme fatigue, dizziness and shortness of breath, which are pretty similar to exhaustion. The iron recommendation to prevent anemia is 15 mg. of iron a day. Athletes are not advised to exceed the 15 mg. Scott also concedes that non meat eating runners are especially challenged on obtaining enough iron. Kristin Clark of Pennsylvania State University reminds us that "Not only can you now buy very lean red meat, ...in some cases it's leaner and lower in fat than poultry."

Whatever your methods, watch the iron intake, be alert for signs of deficiency, try to eat the right foods and supplement when necessary. Your race results will mirror your success.

For additional information on iron deficiencies:

Health, Fitness Nutrition Magazine
Coach SOS
Physician and Sports Medicine
Village Health Magazine
University of Florida Health Advise

Check out the
review on a new nutrition book written by Suzanne Girard-Eberle, a certified dietician and elite endurance athlete.


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