Iron and Running

I came across numbers indicating that almost 56% of runners suffer from iron deficiency. This will definitely influence the way runners perform and feel during and after their training or a race. The main symptoms are fatigue and shortness of breath. You can see the dilemma here: tiredness and shortness of breath go hand in hand with training and racing.

I have done a bit of research and learned a few things about iron and zinc which I will share with you here. I am definitely not an expert or a nutritionist so always check before you start taking supplements, get your iron levels checked and talk with your doctor. If you want to find out more via Google, make sure the articles are scientific rather than ‘popular’ and not older than 6 years or so. Here we go:

The average adult stores between 1 – 3 mg of iron in her/his body. We lose 1 mg/day through sloughing of cells from skin and mucosal surfaces, including the lining of the gastrointestinal tract. Women lose a lot of iron during their menstruation (2 mg/day), and runners lose iron through the micro tear damage occurring with impact sport. In my opinion female (vegetarian) runners should be non-stop on a good quality supplement, unless they feel full of energy or have medical reasons not to.

When taking iron you have to make sure you are not taking it together with zinc. Zinc is however an important participant in the absorption of iron. Zinc and iron have many similar absorption and transport mechanisms and compete for absorption. Iron will still be absorbed but zinc levels will not improve. (The downside of a multivitamin is that there are a few ingredients counter affecting other ingredients.)

Almost 2/3 of the iron in our body is in our haemoglobin (red blood cells). Simply said iron is required for oxygen to travel to all our cells, which makes it a vital mineral, as oxygen provides the fuel that runs our body and its systems.
Zinc is important for cell division (growth and repair), our metabolism, immune system, genetics, and our mood. Zinc is required for proper taste and smell, normal growth and development and it has antioxidant properties and helps destroy free radicals that may contribute to aging, heart disease and cancer.

Both iron and zinc deficiencies have adverse consequences for human health. Iron deficiency results in anaemia, impaired psychomotor development, reduced physical and work capacity, impaired immunity and adverse pregnancy outcomes. Zinc deficiency is associated with fertility reduction, poor pregnancy outcomes, liver disease, kidney disease, sickle cell anaemia, diabetes, mental and behavioural changes, impaired immunity and increased morbidity and mortality.

When your iron levels get tested doctors are generally happy if they are between of 20– 50 ug/l. However, when the iron level in your blood is around 30 it can still feel as if you are hit by a train at the end of the day. 50 Is a lot better. However to perform optimally your level should be 120 ug/l!

To increase absorption iron is best taken on an empty stomach 1 hour before or 2 hours after meals. You can take it with a glass of water and it’s suggested to take vitamin C to support absorption. Iron supplements can cause stomach cramps, nausea and sometimes diarrhoea. In that case you might need to take iron with a small amount of food to avoid this problem.

Calcium (diary), zinc and anti-acids should not be taken at the same time as iron supplements. You should also avoid high fibre foods such as whole grains and raw vegetables and caffeine. Some medication might not work as well with iron, and should be taken 2 hours after the iron as well.

Iron levels returns to optimum between 2-6 months of iron therapy for most people. You should continue taking supplements for another 6-12 months to build up the body’s iron stores in the bone marrow. Ideally you should try and reach a level between 90-120 ug/l.

Taking too much iron is dangerous. The body produces a hormone to regulate the absorption of iron and if this system is compromised people will experience symptoms as explosive abdominal pain, diarrhea and vomiting. Additional symptoms include irritability and lethargy, an increase in heart rate, breathing and blood pressure, a yellow skin color, organ damage, shock and coma. So: best to get your blood levels tested and convince your doctor that you want the quality of your life to be way above ’30-ish’.

On a personal note: I have been taking a good quality iron supplement for years now, as I am a (mainly) vegetarian female runner. Recently my levels where tested in a routine test and my doctor recommended I should ‘start an iron supplement’ as I was around 30. Stating that I already was, the only advice she could give me was ‘well, don’t stop then’. She didn’t ask if I felt energetic, what sport I did and if I was a vegetarian.
As I was used to taking my iron with all my other supplements with my breakfast, which often contains calcium, it probably didn’t get absorbed that well. For the last few weeks I am taking my iron as soon as I get up, with some water and a 1mg vit C tablet, to have breakfast at least an hour later. I am still feeling tired, but less in my muscles and I have noticed that my breathing is easier and deeper when I run. So: fingers crossed.

I hope that helped.