Iron - Are you getting enough?

Iron is crucial for female runners' performance - here's how to avoid iron deficiency.

Posted: 24 November 2010
by Dominique Brady

Iron is key to athletic performance, and a lack of iron can have a dramatic effect. So why do so few female endurance runners know the signs or solutions?

Avoid iron deficiency with the simple steps in our comprehensive guide.

How common is iron deficiency?

Iron deficiency in female athletes is surprisingly common. Studies have found the potential number of affected female athletes anywhere between 10 and 40 per cent. 

Even athletes who appear to be performing well can be suffering from a moderate iron deficiency. University of Oklahoma Professor Emeritus of Medicine and haematology specialist E. Randy Eichner works with the University's sports teams and screens all incoming female athletes for anaemia. Year on year, Eichner finds that between 10 and 20 per cent of new female athletes have low iron levels.

Why is iron important for running?

Iron is important because the body uses it to create haemoglobin - the protein in your blood that carries oxygen. "This is obviously important for athletes because they need enough oxygen to get to their muscles to perform," explains Helen Heap, senior nutritionist at The Marilyn Glenville Clinic.  (

Why do female runners have low iron levels?

Women can be prone to iron deficiency if they have heavy periods and if their diet fails to provide sufficient iron. This can be caused by not eating enough iron rich foods and by consuming foods which inhibit iron absorption (tea and coffee are major culprits).

Men are at a very low risk of iron deficiency because they simply do not lose the volume of blood (and therefore iron) which women do.

Some researchers believe that running further increases the risk of iron deficiency due to loss of iron in sweat, urine and the gastrointestinal bleeding which occurs in a small percentage of long distance runners (around 7-30 per cent of marathon runners).

What are the symptoms?

After going for a blood test in 2005, 1500m World silver medallist Lisa Dobriskey discovered she had an iron deficiency. "I started to feel abnormally tired in training. I was even struggling with my easy runs and just didn't feel myself day to day. It was demoralising as the harder I tried, the worse I ran," says Dobriskey. Symptoms are wide-ranging but can include fatigue, muscle fatigue, breathlessness, pale skin, increased sensitivity to cold and hair loss. reader Eimear McCann experienced similar problems training for this year's Dublin Marathon. In the build up to the race she began to feel increasingly sluggish and slow, but a week before the race the problem became worse. "The exhaustion was all-encompassing and I managed just one seven mile run in the week preceding the big day," Eimear says. After visiting her GP she was diagnosed with a severe iron deficiency and had to withdraw from competing. "I was completely gutted after months of training," says Eimear, advising other women who experience similar unexplained symptoms to head for a check-up.

What should I do if I think I have an iron deficiency?

Head to your GP for a blood test. It might be tempting to self-diagnose and stock up on supplements but it's important to get an official diagnosis. "A blood test is recommended to rule out anything else and to find your actual level of iron. This is checked by measuring haemoglobin and ferritin," explains Heap.

Ferritin is a protein found inside cells that store iron and blood ferritin levels of less than 12 ng/ml indicate an iron deficiency. Heap warns against using supplements to dramatically up your iron levels without diagnosis - taking iron supplements could affect your body's ability to absorb zinc, another vital mineral. In addition, excess iron can be toxic, leading to a condition called hemochromatosis in which bodily organs become damaged by excessive stored iron.

For most people, simply increasing the iron rich foods you eat should be enough to avoid iron deficiency.

What treatments are available?

A range of iron treatments exist. Many GPs prescribe ferrous sulfate tablets - recovery using these takes six to eight weeks. Some people find ferrous sulfate tablets difficult to absorb and it can result in constipation, but alternatives do exist. Lisa Dobriskey uses Spatone, a natural supplement added to water, while nutritionist Heap recommends Biocare Iron Complex which is also easy on the digestive system.

How can I increase the iron in my diet?

Many runners stick to low-fat diets with chicken and fish centre stage, but eating enough iron is just as important as calorie counting. "On the face of it, I was eating a very lean and healthy diet, but I can see now that endurance running without iron in your diet can have debilitating consequences," says Eimear McCann. She has added red meat and leafy greens to her diet as well as using the Spatone supplement - and McCann hopes her marathon dream can be resurrected once she has made a full recovery.

The daily recommended amount for iron is 14.8mg for women. But you don't need to start chugging spinach like Popeye. There are a wide variety of iron-rich foods includes include liver, lean red meat, dried fruit, whole grains, spinach, watercress and curly kale. Find out how much iron the average portion of some of these foods contain here.

Boost your iron levels with plenty of fruit and vegetables - Vitamin C plays an important role in iron absorption.

Unfortunately, common vices including tea, coffee and alcohol inhibit iron absorption. Many fibre- and calcium-rich foods also dent absorption rates, but you don't need to ditch them from your diet altogether. Try iron- and fibre-packed whole grains instead, and avoid eating iron-rich foods at the same time as foods which prevent iron absorption.

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Discuss this article

Posted: 25/11/2010 at 01:31

I am an anaemic vegetarian
Posted: 25/11/2010 at 01:37

They say chocolate has iron it
Posted: 25/11/2010 at 01:39

I hear in USA  that the rich and famous have B12 injections which helps them to boost their energy!

Apparently vitamin B12 tablets are not that good because it gets destroyed in the stomach.

Posted: 25/11/2010 at 02:19

Don't forget a pint of the black stuff 

Posted: 25/11/2010 at 12:25

Posted: 25/11/2010 at 12:30

popeye had it right
Posted: 25/11/2010 at 13:33

Extreme violence and an anorexic girlfriend ?  

Posted: 25/11/2010 at 15:56

I used to take Treacle - sickly stuff
Karen Samuel wrote (see)
I used to take Treacle - sticky stuff

Posted: 25/11/2010 at 17:47

28 pints of Guiness is your daily amount
Posted: 25/11/2010 at 19:24

7 raw eggs

Down the hatch!

Posted: 25/11/2010 at 19:52

Maddy. wrote (see)
popeye had it right

My Mum's organic Spinach or my Dad's organic  callaloo
Posted: 25/11/2010 at 20:01

i am an anaemic vegan
Posted: 26/11/2010 at 20:48

spinach, steak, or guiness, best for it , or wash it down with guiness
Posted: 27/11/2010 at 16:48

There's hardly any iron in guiness - it's a myth!

 "You'd need to drink three pints of Guinness to provide the same amount of iron as a single egg yolk (1.1mg), and alcohol is not good for babies. A pint of Guinness contains 0.3mg of iron, less than three per cent of daily adult needs. Put another way, you'd need to drink 15 pints of Guinness to get the same amount of iron as two Weetabix. " (taken from the daily mail so it must be true!)

Read more:

 But it's also in the Times: "Guinness contains no more iron than most other beers, and that's precious little - a mere 0.3 milligrams a pint, compared with 1.1 milligrams in an egg and a whopping 4.2 milligrams in a bowl of Weetabix. "

 I also read ages ago that there is way more iron in 100g of dried apricots (3.4g) than in a pint of guiness so that's a no brainer for me since I hate guiness!!!

Posted: 02/12/2010 at 11:09


Thanks for that I will buy some dried apricots - I used to eat them once but I got  abit fed up with them.

I would like to start back on the Origanic  Weetabix.

I don't really agree  that it is  a  myth  eating late at night you will put on weight.  Also it's a myth

that vitamin C will stop you getting the flu and cold.

I must say it is great reading

Posted: 02/12/2010 at 11:33

The spinach thing is a myth too, as well as the vit C and late night eating!
Posted: 03/12/2010 at 09:00

I would rather drink 15 pints of guinness than eat two weetabixs or an egg

Posted: 03/12/2010 at 12:03

Spinach is an interesting one.  I'm not an expert so I can only go on what I read but the way I understand it, it's got iron in just like any other green leafy vegetable, but it's not the best source of iron because it also contains oxalic acid which is an iron absorption inhibitor.  See here.

Bottom line, spinach is good for you cos it's a green leafy vegetable, but there are better sources of iron.  I've got a load of chick peas in my salad and I'm making a big chilli this evening, so that should sort me out.

Posted: 03/12/2010 at 12:22

and anyway, I hate the horrid ad-speak "up to" 40% in their article. Where do RW get their info? Pill makers? A cursory search of the web throws up a scientific paper from 1989 that studies male/female runner/non-runner with/without iron supplements that concluded that "the runner's iron status is similar to that of the general population." If they have better or more recent info they should tell us, else we can't distinguish what they say from hearsay like the Popeye spinach myth.
Posted: 03/12/2010 at 13:21

Spinach may contain oxalic acid but around 50% is still available as iron it has alot of other nutrients which make it a useful food.

there are alot of myths about food and alot of confusion and alot of the reserch is biased - ie towards whoever is funding it there are many clever ways of designing experiments to give you results that you want

me - vegan who was ironed up enough to be accepted as a blood donor so therefore NOT anaemic and I don't tend to use suppliments

Posted: 05/12/2010 at 11:26

A friend of mine was diagnosed as borderline anaemic but not low enough to be prescribed iron tablets. Instead the dr told her to make sure she ate some chocolate everyday. She interprereted that as a licence to snarf down curlywurlys - although I'm not sure that's exactly what he meant, apparently it did the trick.
Posted: 05/12/2010 at 18:11

Posted: 05/12/2010 at 21:47

That's a shame because there is no iron in Curly Wurlies
Posted: 06/12/2010 at 17:13

We did wonder at the time...however that was 20 years ago and she's not dead yet! . I think the dr had plain chocolate in mind, which does. Stuff here for anyone who's interested
Posted: 06/12/2010 at 22:13

I hadn't noticed any symptons, but was diagosed as anemic after attempting to give blood, Doc the put me on Iron tablets..... and my running improved, e.g. my half marathon PB reduced from 2'10 to 1'53. Felt as if I was taking performance enhancing drugs!!! Where is the boundary between medication and cheating?
Posted: 11/12/2010 at 18:09

The boundary in this case is that a deficiency is being corrected. More iron on top of that doesn't make you even better and can actually be bad for you.
Posted: 12/12/2010 at 11:01

 SPAMMMMM!   RW please removed all of qezcxadw threads  him self and his  web-site is utter rubbish.  Forumites you have been warned.

Posted: 25/12/2010 at 23:04

Merry Christmas and Happy New Year to all of The RUNNERS WORLD Team
Posted: 25/12/2010 at 23:18

Be careful if you have an underactive thyroid and are on thyroxine, if considering taking iron as a supplement.  It affects the uptake of the thyroxine as does taking a calcium supplement
Posted: 06/01/2011 at 15:06

should i just swallow a 6 inch nail
Posted: 13/01/2011 at 14:37

Get prescription iron its 200mg as apposed to 30mg the max you get in shops! You'll be bouncing off the walls

Posted: 16/01/2011 at 12:29

I have just (yesterday) been put on iron tablets for a severe iron deficiency (as well as told to eat all the things everyone is arguing about above). I'm hoping that the end result is the same as Mc Hilly. Although I have been feeling sluggish most of this year, I just trained harder but when I tried to give blood earlier this month they said I had low Haemoglobin levels, so I couldn't. They referred me to my doctor who gave me a blood test with the results above. So an easy way to test is to give blood; if you are OK you help loads of people in the process. If not you will find out immediately. Happy running.
Posted: 25/08/2011 at 12:17

A year ago after completing the Gaolforce Challenge I suddenly found myself with chapped lips, not any old chapping but seriously sore.  When it didn't go away I eventually went to the Doctors and discovered it was lack of Iron.  I've been taking an Iron supplement ever since, and more recently completely changed my diet to be almost vegan but with heaps of green vegetables.  I'm doing really well on it.  Now training for my first Ultra marathon (

 Pleased to say I no longer have chapped lips!

Posted: 14/12/2011 at 11:45

I was surprised at the level of iron in Ovaltine drink. One cup mixed with milk has 3.6mg - 26% of the RDA along with a whole pile of other good stuff. And it tastes good too. Sadly it won't quite replace coffee for me though!

Also important to know that tea/coffee block iron absorption so best to avoid drinking them after eating.

Posted: 18/12/2011 at 19:10

Note that the comment about haemochromatosis is inaccurate - it's genetic, not something you get from eating excess iron. Furthermore, even of you have it  a) women are likely to have no effect due to extra need for iron. b) men may have ill effects in later life if left undiagnosed. Diet a very small element anyway. The only solution is regular blood taking (all done by the hospital - the blood is no good for donation.) Iron deposits in joints and organs such as liver and (ulimately)n heart. However most runners would use up excess iron deposits at least until their later life. 
Posted: 12/12/2012 at 21:39

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