Even more important than workouts, running, and racing is a problem affecting almost every team in the US that many athletes, coaches, and doctors may not know about iron deficiency. Iron carries oxygen throughout the body and ferritin helps store the iron which is why not having enough of either of these can be so detrimental to runners. Even a slight iron reduction is enough to affect endurance.
Iron and ferritin deficiency can ruin races and careers by being misdiagnosed as overtraining. As a runner, you might be used to feeling tired after workouts and races. But are you feeling exhausted after a normal workout? Are you getting sudden injuries or illnesses? Have you been training hard, but seeing a plateau or a rise in your times? Since these are all very common as runners, you can see why this problem often is ignored or unknown by many athletes.
An important step to take to get not only your iron levels tested, but your ferritin levels as well. Typical blood tests don't provide all the information necessary and since family physicians may not be used to treating runners specifically, it's important to explicitly ask for both an iron and ferritin test. Most coaches and professionals recommend having a blood test done at least once a year, especially for new runners after a year of running or runners with extremely increased mileage or intensity.
So how do the iron levels get so low and why are runners, especially female runners, so affected? The most common reason is through diets. If you aren't eating enough vegetables or red meat, it can quickly lead to a depletion of iron resources. Another main reason is the loss of red blood cells through "foot strike" as your foot hits the hard ground while running. The red blood cells can also be lost through sweat or injury. Additionally, intense training increases the need for red blood cells which increases the demand for an iron turnover. Basically, the more you train, the more iron you need, but the harder it is to supply and store it. While consulting with a doctor and coach is necessary, there are steps to take to help your supply of iron:
1. Eat more greens, lean meats, eggs, and other iron-rich foods. Oranges and other vitamin C foods are also necessary for your diet to help your body absorb the iron
2. Take iron supplements, which are available over-the-counter, but always consult your doctor first as too much iron can result in liver damage
3. Check the quality of your shoes, as hard foot strike for endurance runners can quickly damage your feet
4. Try finding soft places to run to decrease the force of your foot strike
5. Get enough sleep; sleep deprivation causes an increase in the liver hormone that decreases iron absorption
Even if you have no symptoms, all runners should get regularly checked for iron and ferritin levels and ensure your body is at peak performance.