Intravenous iron supplementation in distance runners with low or suboptimal ferritin

Journal article


Garvican, Laura A., Saunders, Philo U., Cardoso, Tanusha, MacDougall, Iain C., Lobigs, Louisa M., Fazakerley, Ruth, Fallon, Kieran E., Anderson, Bev, Anson, Judith M., Thompson, Kevin G. and Gore, Christopher J.. (2014). Intravenous iron supplementation in distance runners with low or suboptimal ferritin. Medicine and Science in Sports and Exercise. 46(2), pp. 376 - 385. https://doi.org/10.1249/MSS.0b013e3182a53594
AuthorsGarvican, Laura A., Saunders, Philo U., Cardoso, Tanusha, MacDougall, Iain C., Lobigs, Louisa M., Fazakerley, Ruth, Fallon, Kieran E., Anderson, Bev, Anson, Judith M., Thompson, Kevin G. and Gore, Christopher J.
Abstract

Purpose: Iron deficiency is prevalent in distance runners and may impair endurance performance. The current practice of oral supplementation is slow and often not well tolerated. The aim of this study was to assess the efficacy of intravenous (IV) iron supplementation (ferric carboxymaltose) compared with oral supplementation (ferrous sulfate) on iron status, hemoglobin mass (Hbmass), and physiological indices of running performance in distance runners. Methods: Twenty-seven highly trained distance runners with low (LOW) (ferritin < 35 [mu]g[middle dot]L-1 and transferrin saturation < 20%, or ferritin < 15 [mu]g[middle dot]L-1) or suboptimal (SUB) iron status (ferritin < 65 [mu]g[middle dot]L-1) were supplemented with either IV iron (Ferinject(R)) or oral (ORAL) supplements (Ferrogradumet) for 6 wk. Iron status and Hbmass were assessed before supplementation and at 1, 2, 4, 6, and 8 wk in the four groups (IV LOW, IV SUB, ORAL LOW, and ORAL SUB). In addition, athletes completed a treadmill running test for running economy, lactate threshold, and V[spacing dot above]O2max before and after supplementation. Results: Both forms of supplementation substantially increased ferritin levels in all four groups. IV supplementation resulted in higher ferritin in both IV groups compared with both ORAL groups from week 1 onward. Hemoglobin concentration did not change substantially in any group. Hbmass increased in IV LOW (mean = +4.9%, 90% confidence interval [CI] = 1.1%-8.9%) and was accompanied by an increase in V[spacing dot above]O2max (mean = +3.3%, 90% CI = 0.4%-6.3%) and run time to exhaustion (mean = +9.3%, 90% CI = 0.9%-18.3%. Conclusions: IV supplementation can effectively increase iron stores in iron-deficient runners within 6 wk and, if Hbmass is compromised, may enhance endurance capacity by facilitating erythropoiesis. Hbmass appears a more sensitive tool for measuring changes in whole body hemoglobin than hemoglobin concentration and may be useful in the diagnosis and follow-up for iron deficiency.

Keywordsiron deficiency; erythropoiesis; hemoglobin mass; VO2max; ferric carboxymaltose
Year2014
JournalMedicine and Science in Sports and Exercise
Journal citation46 (2), pp. 376 - 385
PublisherLippincott Williams & Wilkins
ISSN0195-9131
Digital Object Identifier (DOI)https://doi.org/10.1249/MSS.0b013e3182a53594
Scopus EID2-s2.0-84895074329
Page range376 - 385
Research GroupMary MacKillop Institute for Health Research
Publisher's version
File Access Level
Controlled
Place of publicationUnited States of America
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