Why An Iron Deficiency Predominantly Impacts Female Athletes
A poor iron status is the number one vitamin imbalance in the world. Half of the population is at risk for low iron, the other half for high iron. Even without testing, you can roughly estimate which group you belong to.
Table of Content
- Who is at risk for iron deficiency
- Why you should opt for optimal iron levels
- How to manage your iron deficiency
- Non heme-iron vs heme iron
- Iron absorption
- The problem with iron supplements to combat iron deficiency
- Grass-fed liver pills
- Testing iron status
- Gene mutations that cause abnormal iron status
- Take away
Who is at high risk for iron deficiency
Your body has a greater need for iron because you menstruate, are pregnant, are an athlete or are a frequent blood donor.
- Frequent blood loss from menstruation or blood donation is one of the main causes of low iron status. [*]
- Iron deficiency is probably more common in athletes. When added to physical activity, they are at greatest risk for anemia. [*]
- As a result of rapid growth, pregnant women have a greater need for all vitamins and minerals, including iron. The same counts for teenagers. [*]
- Certain genes or ethnicity also play a role in putting you at greater risk for anemia. [*]
Although this blog is focuses primarily on low iron status, it is worth mentioning that postmenopausal women and women who use contraception (i.e., no monthly bleeding) are most at risk for high iron. So if you are a female athlete, and you use a hormonal IUD or the pill without a scheduled period, your iron may be high.
Even more so if you have one or two mutations of the HFE gene [*], putting you at extra risk for high iron levels and even hemochromatosis – a condition that causes your body to absorb too much iron from the food you eat. [*] This, of course, you can’t know without genetic testing.
Why you should opt for optimal iron levels (not too high, not too low)
Better overall health
If you have anemia or low iron, you probably have less oxygen in your blood. You also cannot transport blood properly to your tissues. Cell regulation decreases with iron deficiency. But that’s not all: your thyroid hormone production will drop, no matter how much iodine or selenium you take — without managing iron you can’t solve the problem. Finally, low iron levels can also impair immune function. [*]
Without enough iron, less oxygen reaches your tissues and muscles, leading to energy loss. Your heart also has to work harder to transport more oxygenated blood through your body, which can make you feel tired. [*] Increased energy is probably the most noticeable and common benefit of optimal iron levels.
Better athletic performance
Low iron is common in female athletes, especially in endurance sports, but also reduces athletic performance. [*] One study showed that getting enough iron through supplements, greatly improved maximum athletic performance. [*]
One of the signs of low iron, or even anemia, is that your muscles feel weak. As mentioned above, when iron levels are low, your muscles don’t get enough oxygen, resulting in loss of muscle tone and elasticity.[*]
A boost in work productivity
Numerous studies have shown that iron deficiency is linked to low productivity and poor cognition. Just as optimizing iron levels can increase energy and performance, it can also increase productivity and focus. [*], [*]
How to manage your iron deficiency
The RDA for iron
The general Recommended Daily Allowance for women is 18 mg and 27 g during pregnancy—for men, it’s 8 mg.
Birth to 6 months
* Adequate Intake (AI)
Non heme-iron vs heme iron
There are two ways to regulate your iron levels: with food and with supplements.
The most effective are foods that contain heme iron (i.e., iron from animal foods), as this is better absorbed than non-heme iron. At the top of the list are clamps, and below that liver and red meat. [*]
There is also iron in plant foods (non-heme iron), such as legumes, leafy vegetables, seaweed and potatoes. [*]
Non-heme iron is less bioavailable, due to its oxidation state. You can get around that by adding vitamin C when you consume those non-heme iron foods. But then you still have to deal with the fact that these non-heme iron foods contain polyphenols and phytates that inhibit iron absorption. [*]
The problem is that most iron-rich plant foods also contain polyphenols and phytates. So there is no option to take them separately. [*]
The bottom line? You can take vitamin C, which will increase bioavailability – but it won’t solve all the bioavailability problems. [*]
The good thing is that you can eat heme iron-containing foods along with foods that contain non-heme iron, and still enjoy the benefits of heme iron. This is because the polyphenols and phytates only inhibit non-heme iron, but not heme iron. So you can eat clamps, liver and red meat along with legumes, potatoes and other foods containing non-heme iron. [*]
There is one more concern: if you consume both heme iron and non-heme iron, that absorption is inhibited by calcium. So you want to take both forms of iron away from dairy, a calcium supplement (for example a multivitamin), natural calcium supplements like bone meal powder or foods with bones in them (like sardines). [*]
The problem with iron supplements to combat iron deficiency
Iron supplements not only have all the bioavailability problems that plant-based iron has. It’s also very likely that the inorganic iron in supplements will run free in the gastrointestinal tract, where it feeds undesirable bacteria, costing gastrointestinal side effects and oxidative stress. [*], [*]
Taking an iron supplement as a cure for low iron or anemia is a short-sighted approach. Besides the side effects a supplement will give you, as a single nutrient it cannot solve all the causes of your anemia or low iron status. [*]
You may have low iron levels because your need for iron is higher, but it may as well be that your body is not able to bind iron to transferrin (a protein that binds to and thus regulates the transport of iron) and move iron throughout the body. To get the iron-form that binds to transferrin, you need a good copper status. Even getting iron out of the liver, where it is originally stored, requires copper. [*]
A good strategy would be, again, as mentioned above, to eat a mix of red meat, liver and clamps. This would give you enough iron to prevent you from deficiencies and enough copper to bind iron to transferrin. [*]
Grass-fed liver pills
If you don’t eat heme iron-rich foods regularly and are struggling with low iron, a whole food grass-fed beef liver supplement may be a solution for you. Here you have a proper daily intake of highly absorbable heme iron and copper and the convenience of a capsule in one.
Testing iron status
Anemia is a problem in the red blood cells, so it is important to look at the red blood cells by doing a complete blood count (MCH, MCV, RDW, CHr). [*] Another test you should consider is:
- A complete iron panel, in which they test for:
- Total iron in your blood
- Total iron binding capacity [*]
From that data, your doctor can calculate:
- Transferrin saturation versus ferritin [*]
Gene mutations that cause abnormal iron status
The most common abnormal iron level that is genetic is high iron. If you have the HFE gene mutation C282Y or H63D, you are at risk for high iron levels. [*]
For example, if you are a woman who menstruates regularly, and perhaps exercises regularly, you are likely to have low iron levels, despite being genetically built with one of the HFE mutations. Once you transition into menopause, your situation suddenly becomes different and you are likely to have high iron levels. [*]
That’s why it’s so important to test your iron status regularly, and if you see abnormal numbers that you can’t resolve with diet, consider a genetic test.
Although high iron levels are often genetic, iron deficiency anemia (IRIDA) can also be caused by certain gene mutations, in this case in the TMPRSS6 gene. [*]
What you can take away as a menstruating woman, athlete, frequent blood donor or pregnant woman is: get tested regularly by doing a complete blood count and a complete iron panel.
Does the test show that you have low iron levels? Then try fresh liver and/or our liver capsules, clamps and red meat. Eat or take this away from dairy, bone meal powder or a calcium supplement. Test again and adjust the dosage of food/supplements.
Are you on birth control or post-menopausal? If so, test accordingly and even consider a genetic test. Does it show that your iron levels are high, or that you are genetically wired for higher iron levels? Then don’t stop eating nutritious iron-rich foods. Try donating blood occasionally and test again.