Intravenous iron does not augment the hemoglobin mass response to simulated hypoxia

Journal article


Garvican-Lewis, Laura A., Vuong, Victor L., Govus, Andrew D., Peeling, Peter, Jung, Grace, Nemeth, Elizabeta, Hughes, David, Lovell, Gregory, Eichner, Daniel and Gore, Christopher J.. (2018) Intravenous iron does not augment the hemoglobin mass response to simulated hypoxia. Medicine and Science in Sports and Exercise. 50(8), pp. 1669 - 1678. https://doi.org/10.1249/MSS.0000000000001608
AuthorsGarvican-Lewis, Laura A., Vuong, Victor L., Govus, Andrew D., Peeling, Peter, Jung, Grace, Nemeth, Elizabeta, Hughes, David, Lovell, Gregory, Eichner, Daniel and Gore, Christopher J.
Abstract

Purpose: Iron is integral for erythropoietic adaptation to hypoxia, yet the importance of supplementary iron compared with existing stores is poorly understood. The aim of the present study was to compare the magnitude of the hemoglobin mass (Hbmass) in response to altitude in athletes with intravenous (IV), oral, or placebo iron supplementation. Methods: Thirty-four, nonanemic, endurance-trained athletes completed 3 wk of simulated altitude (3000 m, 14 h·d−1), receiving two to three bolus iron injections (ferric carboxymaltose), daily oral iron supplementation (ferrous sulfate), or a placebo, commencing 2 wk before and throughout altitude exposure. Hbmass and markers of iron regulation were assessed at baseline (day −14), immediately before (day 0), weekly during (days 8 and 15), and immediately, 1, 3, and 6 wk after (days 22, 28, 42, and 63) the completion of altitude exposure. Results: Hbmass significantly increased after altitude exposure in athletes with IV (mean % [90% confidence interval (CI)], 3.7% [2.8–4.7]) and oral (3.2% [2.2–4.2]) supplementation and remained elevated at 7 d postaltitude in oral (2.9% [1.5–4.3]) and 21 d after in IV (3.0% [1.5–4.6]) supplementation. Hbmass was not significantly higher than baseline at any time point in placebo. Conclusions: Iron supplementation appears necessary for optimal erythropoietic adaptation to altitude exposure. IV iron supplementation during 3 wk of simulated live high–train low altitude training offered no additional benefit in terms of the magnitude of the erythropoietic response for nonanemic endurance athletes compared with oral supplementation.

Keywordsferric carboxymaltose; erythroferrone; hepcidin; hemoglobin mass; altitude training
Year2018
JournalMedicine and Science in Sports and Exercise
Journal citation50 (8), pp. 1669 - 1678
PublisherLippincott Williams and Wilkins
ISSN0195-9131
Digital Object Identifier (DOI)https://doi.org/10.1249/MSS.0000000000001608
Scopus EID2-s2.0-85049833929
Page range1669 - 1678
Research GroupMary MacKillop Institute for Health Research
Publisher's version
File Access Level
Controlled
Place of publicationUnited States of America
EditorsL. B. Gladden
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