In our industrialized world, iron is all around us. It’s in our cars, our buildings, and even our laptops and phones. Iron is an essential part of the infrastructure that composes our daily lives. Life would not be the same without iron. But more than that, we probably wouldn’t even be alive without iron. Iron is just as important inside our bodies as it is outside of them.

What is the role of iron in our bodies?

Iron is an essential mineral in hemoglobin, a protein which enables red blood cells to carry oxygen throughout the body. Oxygen is an essential ingredient in cellular respiration, our bodies’ primary mechanism to extract energy from the high-energy molecules we consume. In other words, oxygen (and by connection iron) are vital to our survival.

Iron is primarily obtained through the diet. Some common sources of iron in food are:

• Red meats and poultry

• Seafood

• White beans, kidney beans, and lentils

• Spinach and other leafy vegetables

• Nuts

What are iron deficiency and iron deficiency anemia?

Iron deficiency is when the body lacks sufficient amounts of iron in the blood. Low iron levels can reduce the availability of hemoglobin and therefore the ability of the body to transport oxygen to its cells.

In severe cases of iron deficiency, low levels of hemoglobin limit production of red blood cells. This results in iron deficiency anemia—a condition characterized by a lack of adequate healthy red blood cells. The symptoms of iron deficiency anemia include:

• Fatigue

• Weakness

• Headaches

• Shortness of breath

• Chest pain or fast heartbeat

• Reduced appetite

Iron deficiency and iron deficiency anemia can have several causes including blood loss (menstruation is a common risk factor), insufficient iron in your diet, and pregnancy. During pregnancy, increased blood volume means that greater consumption of iron is necessary for sufficient hemoglobin and red blood cell production.

In mild cases, iron deficiency anemia can be treated through dietary changes or supplements. However, in severe, untreated cases, it can cause heart problems, complications during pregnancy, and delayed growth in children. It’s important to take actions to diagnose iron deficiency and prevent the development of these complications.

How is iron deficiency diagnosed?

Iron deficiency can be diagnosed through a ferritin test.  During a ferritin test, a blood sample is taken through a needle from your arm. This sample is subsequently analyzed to determine the amount of ferritin—a protein that contains iron—in the blood. Low levels of ferritin can indicate iron deficiency and in some cases iron deficiency anemia.

Normal levels of ferritin vary by gender:

• For men, 24-336 micrograms per liter is considered normal.

• For women, 11-307 micrograms per liter is considered normal.

How does iron deficiency anemia affect athletes?

Because many of the symptoms of iron deficiency can affect athletic performance, proper iron consumption is especially important for athletes. Iron deficiency can also be more prevalent in athletes than the general population. During exercise, iron is lost through sweat, urine, and the GI tract. Additionally, high impact movements, such as the collision of your foot with the ground while running, can result in the destruction of red blood cells. In athletes who menstruate, iron deficiency is even more prevalent.

Because of these factors, athletes may need to consume higher amounts of iron than normally recommended. Athletes can still experience iron deficiency symptoms, even when their ferritin levels are within the acceptable range for the general population. Due to higher iron needs, ferritin levels may need to be as high as 30-40 micrograms in athletes, more than double the lower limit for the general population.

What to do about iron deficiency

While iron deficiency and iron deficiency anemia can affect both athletes and non-athletes, frequent ferritin testing and doctor consultation can help to monitor iron levels. By doctors’ recommendation, iron supplements can be used to address iron deficiency. Moreover, an emphasis on high-iron foods in your diet can help to deter the symptoms of iron deficiency in order to optimize health and athletic performance.