Iron Considerations for Athletes: A Complete Guide from Prevention and Detection to Treatment

If training leaves you exhausted instead of empowered, it might be time to look beyond your workout, and into your iron status. Our Iron Considerations for Athletes Course is an evidence-based, practical on-demand session designed for athletes, coaches, and caregivers who want to better understand the critical role iron plays in performance, recovery, and long-term health.

This 70-minute course covers:

·      The role of iron in energy, oxygen delivery, and performance

·      Who’s most at risk for iron deficiency

·      Strategies to support iron levels through nutrition, timing, and supplementation

·      The impact of under fuelling, inflammation, and hormonal factors on iron metabolism

·      How to boost iron absorption with the right foods, supplements and timing of ingestion

·      Tips on prepping for accurate blood test results and how to screen for iron deficiency

·      How to interpret blood work using athlete-specific cut-offs

·      When and how to supplement safely and effectively (with tips on dosing and side effects)

·      Real life strategies from Melissa’s work with athletes

PLUS, get exclusive resources:

📄 Downloadable PDF of high-iron foods and performance tips

📅 3 meal plans for high-iron eating (vegan, pescatarian, omnivore)

🎥 Unlimited access, watch anytime at your own pace

Why Iron Matters for Athletes

Athletes routinely challenge the limits of human performance, demanding optimal function from every physiological system. Among the many nutrients essential for health and performance, iron plays a particularly critical role. As an essential mineral, iron plays a vital role in oxygen transport, energy production, and overall health. Ensuring adequate iron intake, and understanding iron metabolism, can make all the difference between performing at your best or struggling with fatigue and reduced training capacity.

Patience is required. Iron deficiency isn’t a quick fix as it takes months to replete stores, thus making prevention and screening so important! It takes at least 4-8 weeks to see a noticeable change in ferritin stores. Routine testing in the offseason is key to prevent iron deficiencies during your competitive season.

What are some causes of Iron Deficiency and Who is Most at Risk?

Iron deficiency is surprisingly common in athletes, particularly in endurance sports, where oxygen delivery and red blood cell turnover are in high demand. Athletes, especially those with heavy menstrual cycles, face additional losses. Vegetarians and vegans, who rely primarily on non-heme (plant-based) iron, often absorb less due to the lower bioavailability of these sources. Athletes with digestive disorders, low body fat, a history of under fuelling, or high sweat rates are also more vulnerable. Some common causes are below:

Recognizing the Signs of Deficiency

Many athletes can sometimes overlook the subtle signs of iron deficiency. What begins as general fatigue or trouble maintaining pace can gradually progress into more concerning symptoms, such as shortness of breath, mood changes, and light headedness. In some cases, everyday activities like climbing stairs may start to feel unexpectedly difficult.

Common Symptoms of Iron Deficiency in Athletes Include:

• Reduced mood and motivation

• Reduced endurance or exercise capacity

• Elevated rate of perceived exertion

• Elevated heart rate

• Shortness of breath during training

• Cold extremities (hands or feet)

• Headaches

• Light-headedness

• Poor mood or irritability

  
  

Because these symptoms often develop gradually rather than all at once, early detection is critical. Taking a proactive approach to monitoring and managing iron levels can help athletes avoid performance setbacks, prolonged fatigue, or even injury caused by overexertion.

How much iron do we need?

Enhancers and Inhibitors of Iron Absorption

Hepcidin: The Hormonal Gatekeeper of Iron and why it matters for Athletes

Hepcidin is a liver-produced hormone that plays a key role in iron regulation. It increases after exercise and can remain elevated for several hours, reducing the amount of iron the body absorbs. For athletes, this means that timing may be critical when it comes to iron intake (from food and supplements) and maximizing absorption. We discuss dietary and supplement timing strategies to maximize iron absorption in the Iron Considerations for Athletes Course.

Heme vs. Non-Heme Dietary Iron Absorption

Many people, particularly on social media, believe that simply eating more spinach will boost iron levels. But the reality is more complex. Not all forms of iron are absorbed equally by the body. There are two types of dietary iron:

Why Food Pairing Matters

To improve iron absorption, consider pairing with foods rich in vitamin C, such as citrus fruits, peppers, and berries. Conversely, items such as coffee, tea, and dairy may hinder iron absorption. This can be a significant drawback for athletes who often consume iron fortified cereals with milk and coffee in the morning. The Iron Considerations for Athletes Course will provide 3 sample meal plans with high iron and vitamin C pairings.

Is Under Eating impacting your iron stores?

Under fuelling is a major and frequently ignored cause of iron deficiency. It’s not just under consuming dietary iron, but also calories and carbohydrates around training! Athletes may focus on weight loss or a “clean eating” approach, which might inadvertently lead to low energy availability, low carbohydrate availability, or relative energy deficiency in sport (REDS). Consequently, their iron levels and athletic performance may suffer. The course dives deep into the topic of eating enough and timing of eating for optimal iron status. Would you believe me if I said that prioritizing overall calories and carbohydrates can reduce exercise induced inflammation and support iron metabolism?

Setting yourself up for Accurate Blood Test Results

What Athletes do Before Blood Testing Matters

If you're an athlete getting bloodwork to assess iron status, what you do in the days leading up to the test can significantly affect your results. This rarely gets communicated to athletes! Intense or prolonged exercise just before testing can cause acute inflammation, which may falsely elevate ferritin  (stored iron) levels, making it harder to detect low iron stores. That’s because ferritin is an acute-phase reactant, meaning it rises in response to stress or inflammation, not just iron status. Understanding when to test, how often to screen, and which cut-offs are appropriate for athletes is key to getting an accurate picture. The course and resources covers all of this in detail, including how to prepare for testing, interpret your results, and monitor trends over time.

Bottom Line: Don’t Let Iron Be the Missing Link

Iron deficiency doesn’t just affect how you feel, it directly impacts your capacity to perform, recover, and improve.

Want to dive deeper?

Enroll in the Iron Considerations for Athletes: A Complete Review from Prevention and Detection to Treatment course, a 70-minute evidence-based session that offers practical tips for both athletes, coaches and caregivers to avoid performance issues caused by fatigue from iron deficiency.