Are you a female athlete? Then there is a very good chance that you have an inadequacy of iron or maybe even iron deficiency anemia. Women need to be especially vigilant when it comes to iron levels. Between 9% and 12% of Caucasian women, and nearly 20% of Black and Mexican-American women are iron deficient, while affecting just 2% of adult men!

Having an iron deficiency can significantly impact your quality of life and your overall well-being. But once you know what to look out for, you can easily address this common nutritional deficiency.

First let’s talk about and inadequacy versus a deficiency. An inadequacy of iron means that you lacking iron but you may or may not be showing signs of iron deficiency efficiency. Iron deficiency anemia (IDA) has a stricter definition. To be diagnosed IDA, you must be symptomatic and have low laboratory values in iron. In my sports medicine practice, I see a lot of female athletes that have one or the other. The signs that you have iron problems can be major or minor.

Causes of iron problems

With any cause of iron problems, you are losing iron faster than you can put it in. It doesn’t happen in an acute sense, but over the long term.

Blood loss – Gastrointestinal loss of iron – the main causes of iron deficiency can be caused by GI bleeds, aspirin, non-steroidal medications like ibuprofen, peptic ulcers, aspirin, and menstrual periods all fit in this category.

Dietary – most don’t get enough iron in their diets. And most people don’t eat enough of the proper types of iron, namely from heme and non heme sources. Your body only takes about 20% of iron from non heme sources and about 80% from heme sources. Non-heme sources are vegetables and heme sources are animal based. Even more iron is very difficult to absorb from the diet. It is said that we can only take in about 25mg of elemental iron per day. In pregnancy, this value goes way up.

Absorption – things like irritable bowel syndrome, celiac disease, and GI surgery all greatly affect how well iron is absorbed into the body.

Athletics – things like foot strike hemolysis, hemorrhoids, and trauma all can cause the body to lose iron.

Symptoms of Iron Problems


So are you exhausted and irritable like you cut out carbs for a week? This kind of fatigue often lasts months and not just some days. Prolonged tiredness, known as fatigue, is one of the top symptoms of an iron deficiency. There are often other confounding factors such as a magnesium inadequacy, prescription meds, and alcohol. She because what you much iron in the blood from the disease in doses.

Skin & Eye Problems

Iron deficiency anemia is one of the most common causes of dryness around the eyelids, nails and hands. Angular cheilitis is a cracking around corners of the mail. Paleness of the eyes is a strong sign of an iron deficiency.

Restless Legs Syndrome (RLS)

RLS is actually a nerve problem. This is a neurological disorder characterized by unpleasant sensations in the leg, including throbbing, or creeping, and an uncontrollable urge to move them. According to John Hopkins Universtiy, the single most consistent finding associated with restless leg syndrome (RLS) is an iron deficiency. They also state that even if blood iron levels are normal, patients with RLS often have low levels of iron in their brains. Researches gave 1 gram of intravenous iron to non-anemic patients with mainly normal blood iron levels, found that almost half the participants had at least a moderate improvement in their symptoms. And over 20% were almost completely relieved of symptoms after the iron infusion.

Anxiety, stress and depression

Iron inadequacy may contribute to anxiety and other disorders. Usually it is in combination with other vitamin inadequacies such as vitamin B6. This may happen because the B vitamins and iron play a very important role in the synthesis of tryptophan into serotonin. Serotonin is a neurotransmitter that regulates both mood and sleep. And even more it is often underappreciated that more than 40% of your serotonin comes from your healthy gut bacteria. Other studies have also shown a strong link between iron deficiency and anxiety, stress and depression in young mothers. And in the studies supplementing with iron usually leads to improvement in symptoms.

Feeling cold

If you often complaining of being cold in a room or are always wrapped in a sweater, you might be lacking iron. People contribute this to having a “low thyroid” but this is usually not the case. As iron deficiency is a much more cannot common phenomena. Feeling cold can be linked with many things including malnutrition, decreased fat intake, mineral inadequacies, and of course thyroid disease.

Hair loss and toenails

A thorough review of the research reveals that iron deficiency and inadequacies have a very close link to hair loss and brittle nails. Just like feeling cold, these are often associated with thyroid problems and vitamin inadequacies in the diet.

Simple reasoning suggests that iron deficiency, especially when it turns into anemia, starve your body of oxygen and puts it into an “survival mode” where oxygen is being channeled to support other vital organs. The good news is that you take iron supplements for the proper nutrition and loss and brittle nails often go away without problems.

Keep an eye on your nails too – with an iron deficiency the nail bed can become thin and concave with raised ridges.

Dizziness and vertigo

Vertigo is a specific kind of dizziness meaning that you sense that you are moving or spinning when you’re actually not. This is an unpleasant sensation and can be caused by many things, including iron inadequacy. Again it goes to the logic of for oxygen supply to the brain, and as we have already seen, you can have completely normal blood values, while your brain iron levels may be low. A Swedish study found that vertigo and dizziness were significantly more common in students with iron deficiency.

Diagnosing and treating iron deficiency.

The next challenge is often to find a doctor who is well-versed in iron disorders and that you can get an adequate blood test to diagnose and iron deficiency. And there are studies showing that routine blood tests often come back with iron levels in the normal range but in fact they are missing about 90% of the people with severe iron deficiency. You must have your ferritin levels checked at the same time and have an actual number. If your ferritin level is less than 60 is a very good chance of having iron inadequacy.

And as far as getting enough iron, it is recommended that can consume at least 10 mg of iron today that day, while women should probably get closer to 20. Remember, this is elemental iron, and may not be the actual dose you see on the bottle. And these levels are even higher for pregnant women. Vegetarians and vegans will need to more than 2 times more iron than meat eaters. This is because non-heme iron is much less is absorbed.

From an athletic standpoint iron is very important. Iron is not just for building up your hemoglobin but iron ingestion also actually affects your oxygen transport systems. There are studies that go back and forth showing whether iron is in fact a performance enhancer, but the majority of studies show that adequate iron as well as supplemental iron can help increase the ceiling of the V02 metabolism in the body. And in extreme endurance athletes it is well-known that iron is excreted in sweat. This can sometimes be severe especially in women.

Another subject runner’s must deal with it is something called foot strike hemolysis. Foot strike hemolysis is where anemia can appear despite normal iron stores and cause symptomatic anemia. The red blood cells are thought to be destroyed in the small blood vessels of the feet upon multiple impacts cause running. Foot strike hemolysis in conjunction with a poor diet and iron and together with other sources of iron loss. Can quite easily lead to iron deficiency anemia. In fact, over 50% of all marathoners have some kind of iron deficiency attacking a performance.

When you see the low levels of iron in some foods, you can see how it may be easy to become deficient in iron, particularly if you are a vegetarian woman or pregnant! There is a secret to getting the most iron out of your food. Add a source of vitamin C to an iron-rich food (particularly non-heme iron) and it will boost your absorption of the iron.

Try squeezing some lemon juice over your kale salad, serving your pasta dish with steamed broccoli, or topping your strawberries with a handful of iron-rich nuts and seeds.

You can also eat non-heme iron foods with heme foods to boost the non-heme iron absorption.

Are you worried you may have an iron deficiency? Or have you ever been diagnosed with low iron levels or anemia? Let me know in the comments below or on my Facebook page Doc Edwards Health & Fitness.