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Could Iron Be Affecting Your Race Day Performance?

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by Crystal Toll, PT, CSCS, CMTPT

As a triathlete, having an off race is inevitable. The nature of the sport can lead to so many uncontrollable variables that can make or break a race day performance. Many triathletes are willing to spend time and money on gear, coaching, nutrition and equipment in the hopes of gaining an edge and accomplishing that ideal race. But what if they don’t make a difference?

When things don’t go as planned, we do a lot of self-reflection. Did I not get enough sleep, was my taper too long, did my fuel plan fall short? We can become overwhelmed by so many possibilities. As we overcome the post races blues, we look ahead, tweak our plan and sign up for the next event. Surely, we’ll get it right this time.

But what if we don’t get it right? What if our next race is even worse? What if it feels like someone pulled the plug on our muscles mid-race? What if we crash and burn on the course even though we thought we were doing everything right?

Your race day results may be due to iron deficiency – impaired iron levels in the body can significantly limit athletic performance.

Iron is important for the formation of red blood cells, energy production and brain performance. Some patients with low iron can experience low energy, fatigue, headaches, reduced concentration and decreased athletic performance. High-intensity and endurance training can deplete the body’s iron stores, with reductions of up to 70% observed when compared to the general population.1 Dietary recommendations for daily iron do not consider the increased iron demand caused by exercise.1 A “functional iron deficiency” can be present when iron lab values are low, but still within the normal range. This type of deficiency may affect athletic performance, but not adversely affect general health. 2

Some athletes, regardless of their iron status, resort to oral iron supplementation in hopes of a competitive edge. Before beginning iron supplementation, it’s recommended that you consult with a physician. It’s important to avoid excess iron as it can produce negative effects including acute metabolic encephalopathy, seizures, tachycardia, metabolic acidosis and hypoxia.

If you experience significant fatigue, declining performance or brain-fog, a conversation with your physician about iron is recommended. An iron panel, including ferritin (i.e., the protein that stores iron in cells) is the first step in diagnosis and treatment of an iron deficiency. When discussing laboratory results with your physician, be sure to explain your workout regimen and that it may differentiate you from the general population. Treatment for iron deficiency can include dietary changes, oral iron supplementation, intramuscular or intravenous injection.1

References:

1 Kardasis, William et al. “The IRONy in Athletic Performance.” Nutrients vol. 15,23 4945. 28 Nov. 2023, doi:10.3390/nu15234945

2 Sims, Stacy T et al. “High Prevalence of Iron Deficiency Exhibited in Internationally Competitive, Non-Professional Female Endurance Athletes-A Case Study.” International journal of environmental research and public health vol. 19,24 16606. 10 Dec. 2022, doi:10.3390/ijerph192416606

About Advocate Health

Advocate Health is proud to be the medical provider of USA Triathlon. Headquartered in Charlotte, North Carolina, Advocate Health has a combined footprint across six states – Alabama, Georgia, Illinois, North Carolina, South Carolina and Wisconsin. As the third-largest nonprofit, integrated health system in the United States, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care.

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