How many of you take Iron supplements? My coach told our team to supplement.

Responding because I feel strongly about this topic. In high school, I was iron deficient and could get through training but almost always felt exhausted/like I had gone to the well and dizzy after runs (easy runs and hard workouts) despite sleeping 9-10 hours a night/drinking water/eating healthy etc. Doctors are hesitant to suggest iron to male runners because it has typically been a thing that predominantly affects female runners, but can definitely happen to male distance runners. When I had my blood work done as part of a yearly check-up, I specifically asked to have my ferritin (iron stores) checked and yes, they were very low. Fast forward to today, I've taken iron pills 1x a day for 6-7 years through college and post-grad running and it definitely makes an improvement, I can even tell on days where I forget because I feel dizzy or lightheaded. TLDR it can definitely help if you are low but recommend getting tested first before blindly taking it and definitely follow a doctor's recommendations (i.e. no need to over do it) and more isn't necessarily better

I recommend all runners at least get their ferritin levels checked. There was a study done back in the early 2000s that showed 56% of runners suffer from an iron deficiency. That's almost 2.5 times more prevalent than issues of low iron in non-runners!

In fact, outside of training deficiencies, low iron is one of the most common reasons for poor results during workouts and races.

The research has shown that runners lose more iron than non-runners for a multitude of reasons. Here's a look at some of the big reasons why...

1. You lose iron with each step.

First, a process called foot strike hemolysis occurs in runners, especially those who run high mileage.

Foot strike hemolysis is a process where red blood cells are damaged when the foot hits the ground, thus reducing your hemoglobin levels.

Since runners are taking thousands of extra steps per day, the extra loss of iron compared to non-runners is significant.

2. You lose iron through sweat

According to a study published in the American Journal of Clinical Nutrition, iron loss is directly related to the volume of sweat lost and has been calculated at 22.5 micrograms iron per liter of sweat.

Perhaps another way to phrase the calculation to make it more relatable is that studies suggest that runners may lose about 1.2 milligrams of iron with each gallon of sweat, making up a loss of about 0.3 milligrams of iron per liter of sweat.

It may not seem like much, but daily runs in hot and humid weather have a big impact on your iron levels.

3. Loss of iron from GI tract

Third, loss of iron through the GI tract (primarily the stomach or large intestine) is a problem for some athletes.

Iron loss through the GI tract is fairly minor, but there may be a cumulative effect over months of running that leads to iron deficiency.

4. Loss of iron from menstruation

Finally, female runners have an especially difficult time maintaining proper iron levels since they also lose iron during menstruation.

One of the major issues with getting enough iron is that it's been shown to be notoriously difficult for the body to absorb and utilize.

In fact, iron bioavailability is estimated to be only 14% to 18% for those consuming animal products and as low as 5% to 12% for plant-based eaters.

This is the result of many factors, including...

Iron-rich plant foods often contain phytates, compounds that bind to iron, rendering it inaccessible to the body as it travels through the digestive tract.

Many common foods such as calcium, protein and caffeine have all been shown in research to inhibit the absorption of iron.

There are also the polyphenols (which include tannins), as well as certain micronutrients and proteins in our foods that inhibit absorption.

This is why it's usually recommended runners be on an iron supplement unless they've had their levels tested and they know they are above normal.

Yeah, taking an iron supplement isnt that big of a deal. You guys on here are acting like the coach is trying to inject his kids with epo. It's a damn iron pill! They've been selling Geritol for almost 100 years!

I've had a lot of experience as a coach with iron levels. Here is what I have found:

1-You should have your blood checked before taking iron, but you should check both hemoglobin AND ferritin. It is possible for one to be okay and the other low. We used to check iron levels in the summer before each season started.

2-Too much iron is very rare. If you don't have a rare condition that causes you to store extra iron, taking a pill a day will probably not hurt. Having said that, there is no reason to take iron if you don't need it. Also, it is VERY irresponsible of a coach to tell all athletes to take iron without knowing they need it.

3-Many doctors do not know what a good ferritin level is for an endurance athlete. I have seen many doctors who say that as long as it is above 20 it is okay. That is not high enough. It should be over 60, at least.

4-Always take iron with vitamin C and always avoid any calcium within an hour of taking iron. The vitamin C helps with absorption and the calcium inhibits absorption.

5-Contrary to what I have seen on this thread, low iron can have a huge effect on performance. I have seen at least 3 athletes improve 5K times by 2 minutes or more with proper levels.

6-Pills are fine for most people, but some have to take liquid for better absorption. Also, some do not tolerate it well on their stomach. Intravenous iron is SOMETIMES the only way to get levels up. Again, it is rare, but for some, it is the only way to get iron levels to normal levels.

Iron supplementation should never (IMNSHO) be recommended broadly. It should only be used if there is evidence (blood work) showing a deficiency.

One of the most common hereditary conditions involves the body not being able to rid itself of iron so taking additional iron can be harmful to these people. (Hemachromatosis if you want to look it up.)

Exactly. Oh see a doctor before you do anything. Wouldn't you need to see a doctor before a daily multivitamin too? Or before starting any type of exercise? Oh and see a doctor if you have a runny nose. Don't forget to see the doctor if you have a sore muscle.

So since YOU have never heard of anyone having a problem, you think it does not exist? What a clown...

One does not "overdose" per se, but hemachromatosis is a legit concern.

Coaches should not be giving such specific nutritional recommendations or such a recommendation like that at all.

I don't think anyone is arguing a coach should not recommend seeing a doc...

Rather than iron, I'd suggest lactoferrin. It makes sure the iron you get from food goes where it's supposed to. Any gut disregulation (which is widespread) results in the gut microbes using iron to build microfilms. Lactoferrin counteracts this, and by its nature improves iron levels.

If it ain't broke, don't fix it. My doc says don't supplement iron unless you have a deficiency. If you think that you may have an issue, get a basic blood test to make sure before you supplement.

Because he's an idiot. Maybe he's nice to you, but if you actually read through your own thread instead of downvoting everyone who disagrees with him, you might actually learn something.

I have no doubts that your coach is nice and he means well, but giving bad advice that is potentially harmful to your health is unacceptable.

He has been coaching for 30 yrs and recommends this every year to his team. He’s never seen any issue with it, specifically because nearly all runners are at lower range due to training.

Chill...a large percentage of the population takes daily multivitamins that contain about the same amount of iron as your typical iron supplement pill. Take a normal dosage and you will be fine.

If you eat enough meat and vegetables you probably shouldn't need any supplemental iron. But a lot of runners are Dunning-Krugers when it comes to their diet, they think oatmeal is a food group, and that a 1200-1800 calorie a day diet is fine when it's nowhere close to enough.

Running is also "potentially harmful" so he shouldn't recommend that either.

You’re probably not wrong, but just so we are clear here, I ate plenty of red meat and spinach in college and still became iron deficient. But I was also a heavy coffee drinker at that age, and coffee inhibits iron absorption. So, between the foot strike hemolysis, sweat, and caffeine, I screwed myself. Ferritin of 12, yet a coach never bother to ask what was behind my poor performances after being one of the best runners in a deep running state as a prep.

Not medical advice but here’s information you can look into and discuss with professionals you trust:

General recommendations that may or may not work for you individually:

1. Test (at last) your Ferritin. It’s $20 and you can go to any Quest Lab w/results in less than 24 hours.

ultalabtests.com

Ferritin

The Ferritin Quest lab test contains 1 test with 1 biomarker.

Open link

*can also get CBC w/ it for another $20. Or total iron panel + CBC for ~$55 total.

2. If you ferritin is under 50ng/mL, consider Ferrous bisglycinate. Its absorbs much better than ferrous sulfate and is still cheap. (Nutricost Ferrochel is good) https://a.co/d/gPzJQVa

3. -If ferritin is 30-50ng/mL, optionally take 1 tablet every morning or every other morning. *It really depends, I personally feel better over 50, but some girls/women just never get to 50 and are fine and hemoglobin is good.
-If 15-30 ng/mL take 1 tablet (36mg of actual iron from ferrous bisglycinate) daily in morning.
-If under 15ng/mL take two tablets (72 mg) daily in morning for 4-6 weeks, then 1 tablet daily.
*Ideally take the first thing in the morning with non-calcium added orange juice. If you have stomach issues while running in the morning, then take it within 30 minutes after morning practice OR just before bed.

4. Retest after 4-6 weeks of supplementing.

5. (Well actually # 1): Read research yourself:

Summary of many iron studies: https://www.sciencedirect.com/science/article/pii/S0098299720300364

Easier to read summary:

gssiweb.org

CONTEMPORARY APPROACHES TO THE IDENTIFICATION AND TREATMENT OF IRON DEFICIENCY IN ATHLETES

CONTEMPORARY APPROACHES TO THE IDENTIFICATION AND TREATMENT OF IRON DEFICIENCY IN ATHLETES

Open link

Another good article with research included :

runningwritings.com

Low ferritin and iron deficiency anemia in distance runners: A scientific guide for athletes and coaches

John Davis

Open link

Some notes:

*More isn’t better. The ferrous bisglcyinate amounts given are specifically selected to strike a balance of increasing ferritin relatively quickly while reducing the amount of unabsorbed iron. For simplicity, the more iron you take, the less is absorbed & and absorbed iron isn’t actually harmless- it can have side effects, so minimizing unabsorbed iron does actually matter. Also, don’t take twice a day- it actually reduces absorption.(You can read about this in the articles).
*if you don’t get the iron I recommended pay attention to the actual elemental iron dosage. For example your standard ferrous sulfate tablet is 325mg with 65mg being elemental iron.
*Ideally, training leads to increased total hemoglobin mass (not hemoglobin concentration). That stimulus can come from more mileage, hard training, heat or altitude. A combination of these factors will likely increase your iron needs. In order to make more hemoglobin you need iron, along with mainly folate and B12, and some other nutrients like B2 & copper.

*I have no idea if any of these links will work on here.

Ehh, supposed to say

1. Test (at least)

And there’s probably a ton of other typos.. oh well.