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Runner’s Anemia (Iron Deficiency In Runners)

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Runners often talk about fuel as it pertains to helping them keep moving forward in a distance workout or race. You’ve probably had the conversation yourself and it goes something like this, “How far did you run? What kind of fuel did you take in? How often? Does it upset your stomach?”

Sure, we all know that if you’re workout out for a long period of time we need to be sure to stay adequately fueled and hydrated. In addition to that, most runners I know also discuss carbohydrates, carb loading and what a runner diet might look like. 

One often overlooked topic regarding runners and fuel is iron. Failing to recognize the importance of iron in your diet can leave you feeling tired and with runner’s anemia. Why is this? Let’s look at the science.

The Role of Iron in Performance

Any intense exercise will increase the need for iron in the human body. Critical for the role it plays in transporting oxygen, it stands to reason that if your body is low on iron it will also be low on stamina. Being low on iron does not allow your body to make enough hemoglobin. Without enough hemoglobin in your bloodstream, it can’t transport enough oxygen through the body. You guessed it. The decrease in oxygen being delivered to the organs causes things not to run at top performance.

iron deficiency in runners

Myoglobin, which is very similar to hemoglobin, is specifically responsible for carrying oxygen to muscles. Since aerobic exercise requires aerobic metabolism, and aerobic metabolism needs oxygen, a lack of adequate myoglobin will impart aerobic performance. This translates into a fatigued, low performing athlete. 

Signs Of Iron Deficiency

You’re Always Tired: If you are suddenly feeling fatigued all of the time, an iron deficiency could be the cause. This is of course assuming that you are getting an adequate amount of quality sleep. Some people lie in bed a full eight hours but that sleep is fleeting. If you are sleeping well and according to what your body has historically needed but you are still exhausted all of the time, iron could be what your body needs. 

Your Skin Looks Pale: We are not talking about the normal change in skin tone that comes with the changing of the seasons. If everything else is normal and you are looking pale, you might be low on iron. Since iron gives hemoglobin its red color, adequate iron stores in your body translate to a healthy skin tone. This pale tone can extend to your gums also.

Cold Extremities: If your fingers, toes, hands and feet suddenly feel colder than normal, check into your iron counts. Because a low iron count reduces oxygen throughout the body, your body will naturally pull blood from non-essential parts of the body to essential organs such as the heart. This can result in cold extremities. 

A Racing Heart: Iron deficiency can also result in an increase in heart rate. While runners naturally seem to have lower blood pressure, being low on iron can make you feel like your heart is racing. This is where knowing your normal resting heart rate can come in handy. 

Can Running Make You Anemic?

While running does not exactly cause runner’s anemia, it can certainly play a factor. Endurance athletes need oxygen in the muscles and other parts of the body in order to perform. The more you exercise, the harder your body has to work in order to keep producing what it needs to keep the body moving like a well-oiled machine.

anemia symptoms

For those reasons, an endurance athlete will require more iron than other people. And while an average person might not notice the fatigue from low iron creeping upon them, an endurance athlete is more likely to notice. Since your body is depending on it to keep you moving, iron is necessary. 

Have You Recently Donated Blood?

Each time you donate blood your body loses some iron. This is not mentioned lightly because the last thing we want is for people to stop donating blood. However, being aware of this fact should entice you to either up your iron consumption naturally or add an iron supplement to your diet for a few weeks before and after donating blood.

Donating blood is a selfless act that saves lives. Don’t let a fear of anemia shy you away from doing it!

Why Do Female Runners Have Low Iron?

Since foods rich in iron naturally only absorb iron at a rate of about 15%, it makes sense that it is easy for people to get low on iron. When you couple that with dietary choices that are not iron-rich, the problem becomes clear. While some people take a supplement that gives them adequate iron into the diet, many do not.

Iron can be hard on the person’s stomach which causes some people to not want to take it regularly. Vegetarians and vegans can be particularly challenged to get iron into their diets since red meats are naturally iron-rich foods.

When you add mensuration to the equation women in particular can be plagued with iron deficiencies. While the average person needs about 8 mg of iron per day, menstruating females need over twice that to compensate for the blood loss.  Runner’s anemia is a very real thing, particularly in women. 

How To Prevent Iron Deficiency in Runners

iron rich foods

Luckily, there are many iron-rich foods that can be easily added to the diet to prevent an iron deficiency.

  • Red meat, pork and poultry top the list of foods rich in iron.
  • Seafood is another excellent choice, also adding other nutritional value to the diet.
  • Dark leafy green vegetables such as spinach are excellent sources of iron.
  • Raisins and apricots that have been dried are great ways to add iron. 
  • Cereals fortified with iron.
  • Beans and peas.

There are also tricks to increasing the body’s ability to absorb iron. First, you can combine iron-rich foods with vitamin C to increase your ability to absorb the nutrients. A second thing you can do is cook in a cast iron pan, which helps the process. 

You certainly can figure out a way to keep yourself adequately fueled and moving forward if you are motivated to do so. Even if you had runner’s anemia in the past, you don’t have to accept that as a new normal!


  1. Kathleen Woods, Two Huge Causes Of Anemia In Female Runners, Sports Website
  2. Angie Ferguson, Exercise, anemia, iron and performance, Online News

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