Effects of Exercise Training on Red Blood Cell Production: Implications for Anemia

Abstract

Exercise training can increase total Hb and red cell mass, which enhances oxygen-carrying capacity. The possible underlying mechanisms are proposed to come mainly from bone marrow, including stimulated erythropoiesis with hyperplasia of the hematopoietic bone marrow, improvement of the hematopoietic microenvironment induced by exercise training, and hormone- and cytokine-accelerated erythropoiesis. Anemia is one of the most common medical conditions in chronic disease. The effects of exercise training on counteracting anemia have been explored and evaluated. The results of the research available to date are controversial, and it seems that significant methodological limitations exist. However, exercise training might be a promising, additional, safe and economical method to help improve anemia. There is a need for further investigation into the effects of and guidelines for exercise interventions (especially strength training) in this population of patients, particularly among cancer patients who are undergoing or have undergone chemotherapy or radiation treatments. As the available data are limited, additional research to uncover the underlying mechanisms associated with the effects of exercise training on anemia is clearly warranted.

Arterial Oxygen Content Is Precisely Maintained by Graded Erythrocytotic Responses in Settings of High/Normal Serum Iron Levels, and Predicts Exercise Capacity: An Observational Study of Hypoxaemic Patients with Pulmonary Arteriovenous Malformations

“…This could not be ascribed to differential use of iron tablets: excluding the 25 iron tablet users (6 athletes, 19 non athletic normals) the higher ratio of [100*haemoglobin]/SaO 2 in the athletic group persisted (median 16.6 [IQR 14.7, 20.0] vs 15.2 [IQR 12.2, 17.7], p = 0.016). This would be in keeping with the limited evidence suggesting that exercise training can increase total haemoglobin and red cell mass, attributed to stimulated bone marrow erythropoiesis [49].…”

Early changes of the anemia phenomenon in male 100-km ultramarathoners

“…1e3 In endurance athletes, sports anemia is thought to be mainly related to hemodilution, which can be defined as the increase in plasma volume exceeding the increase of total red cell mass and causing a reduction in RBC count, Hb, or hematocrit. 3,4 Besides hemodilution, various factors contribute to sports anemia, including exercise-induced oxidative stress, iron deficiency, gastrointestinal bleeding, hematuria, and hemolysis resulting from foot-strike and/or from compression of contracting muscles on capillaries. 1,2,5 In the literature, there are remarkable findings reporting significant changes of Hb, hematocrit, and RBC count in runners who strenuously push themselves during a marathon race, with mean cell volume (MCV) and mean cell Hb (MCH) negligibly affected.…”

Proper Exercise Decreases Plasma Carcinoembryonic Antigen Levels with the Improvement of Body Condition in Elderly Women

“…From these studies, it can be speculated that the decrease in cancer risk via greater physical activity may be accomplished by attenuating immune senescence normally occurring with aging (Westerlind 2003). Recently, Hu and Lin (2012) suggested that exercise training can increase total hemoglobin and RBC mass, enhancing oxygen-carrying capacity. They suggested that exercise training improved the hematopoietic microenvironment.…”