Iron Deficiency in Adolescent and Young Adult German Athletes—A Retrospective Study

Abstract

Background: Iron deficiency is a common phenomenon in sports and may lead to impaired physical performance. The aim of the study was to determine the frequency of iron deficiency in competitive athletes and to discuss the resulting consequences. Methods: The data of 629 athletes (339 male, 290 female) who presented for their annual basic sports medicine examination were investigated. Depending on age (<14 years, 15–17 years, ≥18–30 years), four groups ((I.) normal hemoglobin (Hb) and ferritin level (≥30 ng/mL for adults and 15–18-year-olds; ≥20 ng/mL, respectively, ≥15 ng/mL for adolescents and children), (II.) prelatent iron deficiency (ID) (normal Hb, low ferritin), (III.) latent ID (additionally elevated soluble transferrin receptor or decreased transferrin saturation) and (IV.) manifest anemia) were distinguished. In addition, the iron status and exercise capacity of different types of sports were compared. Results: Overall we found an iron deficiency of 10.9% in male (mainly in adolescence) and 35.9% in female athletes (emphasized in adolescence and young adulthood). There were no significant differences in iron status in regard to the different sport types or in maximum performance for the different groups of iron deficiency. Conclusions: Adolescent and female athletes are more likely to have an iron deficiency. Therapy concepts for athletes therefore should pay attention to iron-rich diets.

Evaluation of Serum Iron Parameters among Men Performing Regular Physical Activity—A Preliminary Study

“…Every scientific study showing that physical activity brings benefits and, when performed with caution, does not pose a health risk is important for society in the context of the obesity epidemic associated with improper diet and a sedentary lifestyle [ 3 , 7 , 16 ]. The assessment of iron metabolism and parameters related to maintaining homeostasis of oxygen distribution in the body is particularly noteworthy, as the obtained results may contribute to the spread of sports or, on the contrary, they may discourage physical activity [ 7 , 8 , 14 ].…”

“…As a part of primary care, the determination of serum/plasma iron is a standard first-line test, although it has numerous limitations in the assessment of iron metabolism. Iron concentration depends on both age and sex [ 7 ]. It shows diurnal variability, with higher values observed in the morning.…”

“…In addition to the ferritin dimer, single chains or polymeric structures may also be present in the blood; however, they do not have an iron-binding capacity comparable to that of the ferritin dimer [ 6 , 10 ]. Decreased ferritin concentrations are observed in the course of iron deficiency, whereas increased levels occur during long-term inflammation and when the body is overloaded with iron, e.g., after chemotherapy [ 6 , 7 , 8 ].…”

“…Iron metabolism indices are not evaluated in routine clinical practice. Patients with abnormal blood counts, especially those with reduced hemoglobin (HGB) and hematocrit (HCT) levels and characteristic symptoms of anemia, are qualified for detailed diagnostics in this regard [ 1 , 4 , 7 , 8 ]. Sideropenic (iron-deficiency) anemia is a common abnormality in clinical practice.…”

“…Physical effort, through mechanical forces and oxidative stress, can lead to intravascular hemolysis [ 7 ]. During sports training, blood loss via the urinary tract may occur due to microscopic changes in the renal tubules caused by reduced visceral circulation.…”