Iron Deficiency: Fast Facts You Need to Know

Iron Deficiency: Fast Facts You Need to Know

Iron is a mineral that the body needs to grow and develop. Iron helps make healthy red blood cells that transport oxygen throughout the body. Iron is critical for normal immune function. Iron is the structural component of hundreds of essential molecules. Iron assists antioxidant enzymes.

Iron deficiency is the number one nutritional deficiency in the United States. According to the National Health and Nutrition Examination Survey (NHANES) II. iron deficiency occurs in approximately 11% of women,1-2% of all adults, and in approximately 12.5% of athletes.

It is the No. 1 cause of anemia in athletes. Iron deficiency rates (with or without anemia) in athletes range from 20-50% in women and 4-50% in men.

Iron deficiency anemia occurs when the body does not have enough healthy red blood cells due to a lack of iron in the body.

Two forms of dietary iron

Heme iron is better absorbed than nonheme iron; the absorption of nonheme iron is enhanced by vitamin C.

National dietary surveys indicate that iron is under-consumed by adolescent and premenopausal females.

Iron recommendations vary between adults and teens

What causes iron deficiency

Iron losses occur from blood loss in the gastrointestinal (GI) tract, microscopic losses in urine, hemolysis of red blood cells (RBC) breakdown, menstrual cycle, sweat loss, and intense exercise.

Non-steroidal anti-inflammatories (NSAIDs) like ibuprofen, Advil, and naproxen deplete iron and folate. Frequent use of medications with GI side effects such as aspirin and non-steroidal anti-inflammatories like ibuprofen or naproxen can cause or worsen iron deficiency.

Physical activity particularly high intensity and endurance types increase iron losses by as much as 70% when compared to sedentary populations. Athletes lose more iron due to heavy sweating as well as increased blood loss in the urine and GI tract.

Causes range from a variety of health issues to simply overtraining or even lack sleep. Any athlete that experiences a decrease in training or performance coupled with symptoms should seek out their primary care doctor for further testing and analysis.

Signs and symptoms of low iron

Weakness, fatigue, decreased physical endurance, feeling hot or cold, diminished immune response, alterations in energy levels, cognitive performance, and overall behavior. Iron deficiency is not the only cause of these common symptoms.

Food sources

Iron in meat, fish, and eggs is easily absorbed by the body but the iron in plant sources is attached to phytates that bind iron in foods.

Following a plant-based diet and limiting animal iron sources can be a challenge. As a practitioner, I meet the client where they are at but do share that consuming animal protein will offer greater iron to support their health and performance goals.

Guidance on increasing iron as a plant-based athlete

Pair leafy greens (bok choy, kale, spinach) with a source of vitamin c (broccoli, strawberries, bell peppers, and kiwi) –This can increase the absorption by up to 67%! (3)

Cooking food in cast iron or stainless steel cookware also aids in iron absorption (cook all veggies and protein in the cast iron skillet)

Eat more beans, lentils, edamame, baked potatoes, and Iron-fortified oatmeal (higher sources of iron).

Lima beans
Red beans
Kidney beans

Drink tea or coffee separately from an iron-containing meal or snacks. Caffeine inhibits iron absorption.

Additional ways to combine vitamin C-rich foods with beans

Drain a can of pineapple cubes and add them to canned baked beans
Toss cooked black beans with shredded cabbage in your favorite coleslaw recipe
Sauté red peppers and onions in olive oil and stir into the white navy or Great Northern beans (cast iron pan)
Add any type of cooked beans to a spinach or kale salad with pineapple or fruit

Additional ways to combine vitamin C-rich foods with beans

Blend up leafy greens and fruits rich in vitamin C with your smoothies (you can even add beans – I promise it is a neutral taste)
Eat more lean red meat, chicken, seafood, beans, lentils, edamame, baked potatoes, and Iron-fortified oatmeal (higher sources of iron).

Sauté red peppers and onions in olive oil and stir into the white navy or Great Northern beans (cast iron pan)
In a skillet prepare steak, spinach, or collard greens paired with berries (best way to increase iron)

When young athletes or adults we start with simple guidance to help increase iron

Set meal goals: 4 oz of flank steak 2-3 x/week paired with leafy greens
Snack idea: A side of roasted chickpeas paired with pineapple
Snack idea 2: A 1/2 cup of mixed berries paired with fortified oatmeal

Before taking an iron supplement to correct an iron deficiency you should contact your physician and work with a dietitian to raise iron levels properly. It is best to work closely with a dietitian to ensure you or your young athlete is getting the proper amount if iron to avoid health and performance consequences. We have worked with hundreds of teen athletes and plant-based adults that have struggled with low iron. We can help you too! Contact us for student-athlete coaching or for a virtual presentation for your sports team.

In good faith, health, and athletic performance,

Wendi Irlbeck, MS,RDN,LD,CISSN

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