We discuss iron deficiency in endurance athletes with Dr Rich Burden who works for the English Institute of Sport and has academic affiliations with St Mary's University and Loughborough University. He's an expert when it comes to iron and iron deficiency anaemia - he did his PhD in iron deficiency and iron repletion in elite endurance athletes.
05:20 Helen explains some of her symptoms in the lead up to being diagnosed with iron deficiency anaemia including feeling lethargic, shortness of breath, struggling to do easy runs, lacking energy, unable to hit certain intensities on the bike and struggling with heavy legs.
10:30 Why iron deficiency anaemia doesn't present overnight and can take some time to present itself. 'if iron deficiency occurred overnight, that would instantly cause you to start asking questions, but it creeps up on you, so it is not noticable over short periods of time. It's not until you're at the top of peak training that it can being obvious.'
13:40 If finger prick blood tests at home would pick up iron deficiency 'for Haemoglobin, yes, but as long as you know what you are looking for and what your normal is. For a lot of people when iron deficiency is slowly deteriorating over time, you could take a blood test which is in the 'normal range' but it might not be in the normal range for you.
16:00 Why iron is crucial for health. 'if at any point your iron status is compromised, it will compromise the number size and health of red blood cells which means the ability of the red blood cells to transport oxygen around the body is compromised. '
17:53 Ferritin is your iron store. If your iron store is depleted then your ability to make healthy new blood cells is reduced and therefore you find exercise harder. Iron is key to transport oxygen around the body and for your muscles to take that oxygen out of the blood and turn it into energy. If those systems are depleted, your ability to exercise is compromised.
19:20 What is the difference being iron deficient and having iron deficiency anaemia? Iron deficiency anaemia is the last stage of iron deficiency.
23:30 How iron deficiency can also occur in men, even though it is more prevalent in women because menstruating women loose iron through their periods.
23:40 Why endurance athletes are more susceptible to iron deficiency, including muscular micro traumas, intravascular hemolysis (the destruction of red blood cells). Endurance runners have a greater rate of red blood cell destruction because of the impact forces and striking the ground so often.
26:00 The role of diet and nutrition in relation to iron deficiency. Vegetarians are more at risk of iron deficiency but it doesn't always have to be red meat. There are iron fortified cereals, pasta, bread, nuts. For vegans and for vegetarians it's a bit more complicated but there are expert nutritionists out there who have dietary restrictions
30:00 Iron supplementation - is it worth it? There is no evidence to show that if you are not iron deficient then taking a supplement would do anything positive. There are risks of being iron deficient but there are also risks of having too much iron in your system.
33:00 The role of iron infusions. "The problem with oral supplements is that they have to go through the gut and so you lose a lot of iron that way, so it can take months for someone to have their iron deficiency corrected."
34:38 Why taking iron supplements is not a form of doping or performance enhancing. "There is no evidence to suggest that giving someone iron if they don't need it will enhance performance, unless it is in combination with other things that we know will improve performance, like EPO."
37:40 The role of hepcidin in iron absorption.
41:10 Why timing is important to support absorption of iron.
44:15 Are there any differences between pre and post menopausal women and iron deficiency and any particular factors to take into account?
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