“Iron deficiency doesn’t announce itself the way a strained hamstring or shin splint does. Instead, performance quietly deteriorates”
Why Iron Matters
Endurance performance depends on oxygen delivery
Iron carries oxygen in the blood
Supports energy production and muscle function
Why Runners Are at Risk
High training volume increases iron loss
Foot-strike (impact) breaks down red blood cells
Sweat losses add up over time
Growth increases iron needs (teen athletes)
Hard training reduces absorption temporarily
Every Day Habits
Eat iron-rich foods (especially red meat)
Undereating = under consuming iron
Hydration + recovery matter
When Food Isn’t Enough
Some athletes need supplementation
Food first → supplements if needed
Guidelines for supplements:
Take with Vitamin C
Avoid caffeine (impacts iron absorption
Often every-other-day dosing
Takes 3–6 months to improve
Do not supplement without testing/doctor guidance
Testing and Monitoring
We recommend testing 2x/year (June & January).
Testing after experiencing symptoms = TOO LATE. Prevention is our goal
Ask SPECIFICALLY for ferritin level (key marker)
Standard lab “normal” is NOT optimal for athletes
Do not test when sick
Track levels over time
What This Means for your Athlete
We see this impact athletes every season—monitoring matters
Improved performance (school and sports) and mental health
Reduced risk of burnout and injury
Long-term health and development
If iron is low, coaches may:
Adjust training intensity
Reduce impact (more cross training)
Modify workouts
Monitor fatigue more closely
This is about protecting long-term health and development
Sources & References
Nicole Mackey, MS, RD, CSSD
American College of Sports Medicine (ACSM)