Iron deficiency – be careful to supplement

Iron deficiency – be careful to supplement

Iron supplementation has become very common for athletes of all abilities, particularly women, stemming from a belief that red blood cells get broken down by the “excessive pounding” of regular running on hard surfaces and that more iron is required to rebuild it. Therefore the term “exercise-induced anemia” has come in use. While evidence exists that very active people have higher iron requirements than sedentary individuals, you will want to be extremely careful before considering iron supplementation because one factor has long been hidden from the eyes of doctors and nutritionists.

Earlier today, we spoke about “Darwinian medicine”, the foundation for all health and nutritional advice we give at ChampionsEverywhere, which is simply the study of how the body has evolved to defend itself and what conditions optimise health. A little known fact is that one of these defenses is called “iron withholding” and that this defense is often unwittingly frustrated by our doctors and nutritionists, thus compromising your health and recovery.

Iron supplementation increases risk of infection

Several studies have shown how iron supplementation increases the risk of infection. One particularly memorably one showed that Zulu men, who often drink beer made in iron pots, regularly get a serious liver infection caused by amoeba. Less than 10 percent of Masai tribesman on the other hand, suffer from such infections. At one stage, well-meaning investigators gave iron supplements to Somali nomads to counter the low levels they had found. Shortly thereafter 38 percent of those on supplementation had infections versus 8 percent of those who did not take it.

As an athlete, one of your key priorities is to stay clear of illness and infection and thankfully your body has evolved several responses to keep you clear of such malaise. When you feel symptoms of iron deficiency, you will likely see a doctor and get prescribed supplementation or you will take it on the advice of some well-meaning fellow runner or specialist.

Transferrin transporting iron
Transferrin transporting iron

Protein deficiency the real culprit?

So why is this a problem? You have probably guessed by now: iron is a key resource for bacteria and we have evolved responses to keep it from them when we are infected. The key to this process is a protein called transferrin  which binds iron tightly in your body and only releases it to cells with the “right number plate” (which does not include bacteria. Unfortunately, people who are protein deficient have less than ten percent of the normal levels and in such cases iron supplementation can lead to fatal infection as iron will become freely available in your bloodstream for bacteria to feast on at will.

Next time you are told you are iron deficient, find out first if you are “under the weather” and likely suffering from an infection. In such cases iron supplementation would be a grave mistake. Secondly, look at your food intake and see if you might be protein deficient. This problem would need to be addressed first. Finally, if you have been chronically fatigued, as is the case when you are over-trained, your immune system will be largely shut down and you are likely infected and in defense mode already. In that case, iron supplementation will only knock you further off the edge. Look at iron deficiency as a symptom – not the cause of any fatigue or tiredness your are feeling.


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Director and coach at Borg Coaching Services
Rene Borg is the head coach of Glendalough AC and a passionate runner competing over all distances and terrains.