Iron deficiency and anaemia in athletes

Book chapter

Peeling, Peter, McKay, Alannah and Sim, Marc. (2023). Iron deficiency and anaemia in athletes. In In Karakochuk, Crystal D., Zimmermann, Michael B., Moretti, Diego and Kraemer, Klaus (Ed.). Nutritional anemia pp. 115-124 Springer. https://doi.org/10.1007/978-3-031-14521-6_9

Publication dates
Authors	Peeling, Peter, McKay, Alannah and Sim, Marc
Editors	Karakochuk, Crystal D., Zimmermann, Michael B., Moretti, Diego and Kraemer, Klaus
Abstract	Iron deficiency (ID) is a common condition in athlete populations, resulting from the myriad of exercise-related mechanisms that underpin iron utilisation and iron loss. This mineral is fundamental to exercise performance, physical capacity and human adaptation to training; however, these factors are compromised when ID is left to progress in severity to states of anaemia. Accordingly, nutritional interventions in the form of increased dietary iron intake, oral iron supplementation and/or parenteral iron administration may all be considered as part of any plan to treat ID. The appropriate treatment strategy should be reflective of the deficiency severity and should be planned in consultation with trained dietetics and medical providers. The following chapter considers this prospect in detail.
Page range	115-124
Year	2023
Book title	Nutritional anemia
Publisher	Springer
Place of publication	Cham, Switzerland
Edition	Second edition
Series	Nutrition and health
ISBN	9783031145209
	9783031145216
	9783031145230
ISSN	2628-197X
	2628-1961
Digital Object Identifier (DOI)	https://doi.org/10.1007/978-3-031-14521-6_9
Scopus EID	2-s2.0-85212496339
Research or scholarly	Scholarly
Publisher's version	License All rights reserved File Access Level Controlled
Output status	Published
Online	15 Dec 2022
Print	16 Dec 2022
Publication process dates
Deposited	27 Jun 2025
Additional information	© Springer Nature Switzerland AG 2022, corrected publication 2023.

Permalink -

https://acuresearchbank.acu.edu.au/item/91zx9/iron-deficiency-and-anaemia-in-athletes

Restricted files

Publisher's version

(1 files)

13
total views
0
total downloads
13
views this month
0
downloads this month

These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Perceived negative menstrual cycle symptoms, but not changes in estrogen or progesterone, are associated with impaired cycling race performance

Smith, Ella S., McCormick, Rachel, McKay, Alannah K. A., Ackerman, Kathryn E., Elliott-Sale, Kirsty J., Stellingwerff, Trent, Harris, Rachel and Burke, Louise M.. (2025). Perceived negative menstrual cycle symptoms, but not changes in estrogen or progesterone, are associated with impaired cycling race performance. Medicine and Science in Sports and Exercise. 57(3), pp. 590-599. https://doi.org/10.1249/MSS.0000000000003587

Sweat characteristics and fluid balance responses during two heat training camps in elite female field hockey players

Goods, Paul S. R., Wall, Bradley, Galna, Brook, McKay, Alannah K. A., Jennings, Denise, Peeling, Peter and Watson, Greig. (2024). Sweat characteristics and fluid balance responses during two heat training camps in elite female field hockey players. International Journal of Sport Nutrition and Exercise Metabolism. 34(2), pp. 79-87. https://doi.org/10.1123/ijsnem.2023-0159

Auditing the representation of hormonal contraceptives in studies assessing exercise performance in women

Flood, Tessa R., Clausen, Emma, Kuikman, Megan, Smith, Ella, McKay, Alannah Kelli Anique, Burke, Louise Mary and Elliott-Sale, Kirsty J. (2024). Auditing the representation of hormonal contraceptives in studies assessing exercise performance in women. Journal of Sports Sciences. 42(9), pp. 825-839. https://doi.org/10.1080/02640414.2024.2368762

Myths and methodologies : Standardisation in human physiology research—should we control the controllables?

Merrell, Lucy H., Perkin, Oliver J., Bradshaw, Louise, Collier-Bain, Harrison D., Collins, Adam J., Davies, Sophie, Eddy, Rachel, Hickman, James A., Nicholas, Anna P., Rees, Daniel, Spellanzon, Bruno, James, James, McKay, Alannah K. A., Smith, Harry Alex, Turner, James Edward, Koumanov, Francoise, Maher, Jennifer, Thompson, Dylan, Gonzalez, Javier T. and Betts, James A.. (2024). Myths and methodologies : Standardisation in human physiology research—should we control the controllables? Experimental Physiology. pp. 1099 - 1108. https://doi.org/10.1113/EP091557

Low carbohydrate, high fat diet alters the oral microbiome without negating the nitrite response to beetroot juice supplementation

Cato, Louise E., McKay, Alannah K. A., L’Heureux, Joanna E., Vanhatalo, Anni, Jones, Andrew M., Askew, Christopher D., Slater, Gary J. and Burke, Louise M.. (2023). Low carbohydrate, high fat diet alters the oral microbiome without negating the nitrite response to beetroot juice supplementation. Nutrients. 15(24), p. Article 5123. https://doi.org/10.3390/nu15245123

Iron absorption in highly trained male runners : Does it matter when and where you eat your iron?

McKay, Alannah K. A., Anderson, Bryce, Peeling, Peter, Whitfield, Jamie, Tee, Nicolin, Zeder, Christophe, Zimmermann, Michael B., Burke, Louise M. and Moretti, Diego. (2023). Iron absorption in highly trained male runners : Does it matter when and where you eat your iron? Medicine and Science in Sports and Exercise. 56(1), pp. 118-127. https://doi.org/10.1249/MSS.0000000000003272

Timing is everything, but does it really matter? Impact of 8-weeks morning versus evening iron supplementation in ballet and contemporary dancers

Attwell, Caitlin, McKay, Alannah, Sim, Marc, Dugan, Cory, Nicholas, Joanna, Hopper, Luke and Peeling, Peter. (2023). Timing is everything, but does it really matter? Impact of 8-weeks morning versus evening iron supplementation in ballet and contemporary dancers. European Journal of Sport Science. 23(12), pp. 2275-2282. https://doi.org/10.1080/17461391.2023.2224285

Adherence to a ketogenic low-carbohydrate, high-fat diet is associated with diminished training quality in elite racewalkers

McKay, Alannah K. A., Ross, Megan L. R., Tee, Nicolin, Sharma, Avish P., Leckey, Jill J. and Burke, Louise M.. (2023). Adherence to a ketogenic low-carbohydrate, high-fat diet is associated with diminished training quality in elite racewalkers. International Journal of Sports Physiology and Performance. 18(7), pp. 686-694. https://doi.org/10.1123/ijspp.2022-0351

Female athlete representation and dietary control methods among studies assessing chronic carbohydrate approaches to support training

Kuikman, Megan A., McKay, Alannah K. A., Smith, Ella S., Ackerman, Kathryn E., Harris, Rachel, Elliott-Sale, Kirsty J., Stellingwerff, Trent and Burke, Louise M.. (2023). Female athlete representation and dietary control methods among studies assessing chronic carbohydrate approaches to support training. International Journal of Sport Nutrition and Exercise Metabolism. 33(4), pp. 198-208. https://doi.org/10.1123/ijsnem.2022-0214

Factors influencing the hepcidin response to exercise : An individual participant data meta-analysis

Fensham, Nikita C., Govus, Andrew D., Peeling, Peter, Burke, Louise M. and McKay, Alannah K. A.. (2023). Factors influencing the hepcidin response to exercise : An individual participant data meta-analysis. Sports Medicine. 53(10), pp. 1931-1949. https://doi.org/10.1007/s40279-023-01874-5

Iron regulation and absorption in athletes : contemporary thinking and recommendations

Peeling, Peter and McKay, Alannah Kelli Anique. (2023). Iron regulation and absorption in athletes : contemporary thinking and recommendations. Current Opinion in Clinical Nutrition and Metabolic Care. 26(6), pp. 551-556. https://doi.org/10.1097/MCO.0000000000000966

Menstrual cycle hormones and oral contraceptives : a multimethod systems physiology-based review of their impact on key aspects of female physiology

D'Souza, Alysha C., Wageh, Mai, Williams, Jennifer S., Colenso-Semple, Lauren M., McCarthy, Devin G., McKay, Alannah Kelli Anique, Elliott-Sale, Kirsty J, Burke, Louise Mary, Parise, Gianni, Macdonald, Maureen, Tarnopolsky, Mark and Phillips, Stuart. (2023). Menstrual cycle hormones and oral contraceptives : a multimethod systems physiology-based review of their impact on key aspects of female physiology. Journal of Applied Physiology. 135(6), pp. 1284-1299. https://doi.org/10.1152/japplphysiol.00346.2023

Use of Buffers in Specific Contexts : Highly Trained Female Athletes, Extreme Environments and Combined Buffering Agents - A Narrative Review

Carr, A, McKay, Alannah Kelli Anique, Burke, Louise Mary, Smith, Ella, Urwin, Charles S., Convit, Lilia, Jardine, William T., Kelly, Monica K. and Saunders, Bryan. (2023). Use of Buffers in Specific Contexts : Highly Trained Female Athletes, Extreme Environments and Combined Buffering Agents - A Narrative Review. Sports Medicine. 53, pp. 25-48. https://doi.org/10.1007/s40279-023-01872-7

The Impact of a Short-Term Ketogenic Low-Carbohydrate High-Fat Diet on Biomarkers of Intestinal Epithelial Integrity and Gastrointestinal Symptoms

McKay, Alannah Kelli Anique, Wallett, Alice M., McKune, Andrew, Periard, Julien, Saunders, Philo, Whitfield, Jamie, Tee, Nicolin, Heikura, Ida, Ross, Megan Louise Rhys, Sharma, Avish P., Costa, Ricardo J.S. and Burke, Louise Mary. (2023). The Impact of a Short-Term Ketogenic Low-Carbohydrate High-Fat Diet on Biomarkers of Intestinal Epithelial Integrity and Gastrointestinal Symptoms. International Journal of Sport Nutrition and Exercise Metabolism. 33(6), pp. 305-315. https://doi.org/10.1123/ijsnem.2023-0009

Short severe energy restriction with refueling reduces body mass without altering training-associated performance improvement

Burke, Louise M., Whitfield, Jamie, Ross, Megan L., Tee, Nicolin, Sharma, Avish P., King, Andy K., Heikura, Ida A., Morabito, Aimee and McKay, Alannah K. A.. (2023). Short severe energy restriction with refueling reduces body mass without altering training-associated performance improvement. Medicine and Science in Sports and Exercise. 55(8), pp. 1487-1498. https://doi.org/10.1249/MSS.0000000000003169

The impact of acute calcium intake on bone turnover markers during a training day in elite male rowers

Lundy, Bronwen, McKay, Alannah K. A., Fensham, Nikita, Tee, Nicolin, Anderson, Bryce, Morabito, Aimee, Ross, Megan L. R., Sim, Marc, Ackerman, Kathryn E. and Burke, Louise M.. (2023). The impact of acute calcium intake on bone turnover markers during a training day in elite male rowers. Medicine and Science in Sports and Exercise. 55(1), pp. 55-65. https://doi.org/10.1249/MSS.0000000000003022

Auditing the representation of female versus male athletes in sports science and sports medicine research : Evidence-based performance supplements

Smith, Ella S., McKay, Alannah K. A., Kuikman, Megan, Ackerman, Kathryn E., Harris, Rachel, Elliott-Sale, Kirsty J., Stellingwerff, Trent and Burke, Louise M.. (2022). Auditing the representation of female versus male athletes in sports science and sports medicine research : Evidence-based performance supplements. Nutrients. 14(5), p. Article 953. https://doi.org/10.3390/nu14050953

Sequential submaximal training in elite male rowers does not result in amplified increases in interleukin-6 or hepcidin

Fensham, Nikita C., McKay, Alannah K. A., Tee, Nicolin, Lundy, Bronwen, Anderson, Bryce, Morabito, Aimee, Ross, Megan L. R. and Burke, Louise M.. (2022). Sequential submaximal training in elite male rowers does not result in amplified increases in interleukin-6 or hepcidin. International Journal of Sport Nutrition and Exercise Metabolism. 32(3), pp. 177-185. https://doi.org/10.1123/ijsnem.2021-0263

Fuelling the female athlete : Auditing her representation in studies of acute carbohydrate intake for exercise

Kuikman, Megan A., Smith, Ella S., McKay, Alannah K. A., Ackerman, Kathryn E., Harris, Rachel, Elliott-Sale, Kirsty J., Stellingwerff, Trent and Burke, Louise M.. (2022). Fuelling the female athlete : Auditing her representation in studies of acute carbohydrate intake for exercise. Medicine and Science in Sports and Exercise. 55(3), pp. 569-580. https://doi.org/10.1249/MSS.0000000000003056

Methodological considerations for investigating iron status and regulation in exercise and sport science studies

McKay, Alannah K. A., Sim, Marc, Moretti, Diego, Hall, Rebecca, Stellingwerff, Trent, Burden, Richard J. and Peeling, Peter. (2022). Methodological considerations for investigating iron status and regulation in exercise and sport science studies. International Journal of Sport Nutrition and Exercise Metabolism. 32(8), pp. 359-370. https://doi.org/10.1123/ijsnem.2021-0343

Six days of low carbohydrate, not energy availability, alters the iron and immune response to exercise in elite athletes

McKay, Alannah K. A., Peeling, Peter, Pyne, David B., Tee, Nicolin, Whitfield, Jamie, Sharma, Avish P., Heikura, Ida A. and Burke, Louise M.. (2022). Six days of low carbohydrate, not energy availability, alters the iron and immune response to exercise in elite athletes. Medicine and Science in Sports and Exercise. 54(3), pp. 377-387. https://doi.org/10.1249/MSS.0000000000002819

Short-term very high carbohydrate diet and gut-training have minor effects on gastrointestinal status and performance in highly trained endurance athletes

King, Andrew J., Etxebarria, Naroa, Ross, Megan L., Garvican-Lewis, Laura, Heikura, Ida A., McKay, Alannah K. A., Tee, Nicolin, Forbes, Sara F., Beard, Nicole A., Saunders, Philo U., Sharma, Avish P., Gaskell, Stephanie K., Costa, Ricardo J. S. and Burke, Louise M.. (2022). Short-term very high carbohydrate diet and gut-training have minor effects on gastrointestinal status and performance in highly trained endurance athletes. Nutrients. 14(9), p. Article 1929. https://doi.org/10.3390/nu14091929

Managing female athlete health : Auditing the representation of female versus male participants among research in supplements to manage diagnosed micronutrient issues

Smith, Ella S., McKay, Alannah K. A., Kuikman, Megan, Ackerman, Kathryn E., Harris, Rachel, Elliot-Sale, Kirsty J., Stellingwerff, Trent and Burke, Louise M.. (2022). Managing female athlete health : Auditing the representation of female versus male participants among research in supplements to manage diagnosed micronutrient issues. Nutrients. 14(16), p. Article 3372. https://doi.org/10.3390/nu14163372

Short-Term Carbohydrate Restriction Impairs Bone Formation at Rest and During Prolonged Exercise to a Greater Degree than Low Energy Availability

Fensham, Nikita, Heikura, Ida, McKay, Alannah Kelli Anique, Tee, Nicolin, Ackerman, Kathryn and Burke, Louise Mary. (2022). Short-Term Carbohydrate Restriction Impairs Bone Formation at Rest and During Prolonged Exercise to a Greater Degree than Low Energy Availability. Journal of Bone and Mineral Research. 37(10), pp. 1915-1925. https://doi.org/10.1002/jbmr.4658

A repeated shuttle sprint test with female and male international field hockey player is reliable and associated with single sprint but not intermittent endurance performance

Goods, Paul S. R., McKay, Alannah K., Appleby, Brendyn, Veli, David, Peeling, Peter and Jennings, Denise. (2022). A repeated shuttle sprint test with female and male international field hockey player is reliable and associated with single sprint but not intermittent endurance performance. PLoS ONE. 17(7), p. Article e0271244. https://doi.org/10.1371/journal.pone.0271244

Dietary iron and the elite dancer

Attwell, Caitlin, Dugan, Cory, McKay, Alannah K. A., Nicholas, Joanna, Hopper, Luke and Peeling, Peter. (2022). Dietary iron and the elite dancer. Nutrients. 14(9), p. Article 1936. https://doi.org/10.3390/nu14091936

Methodology review : A protocol to audit the representation of female athletes in sports science and sports medicine research

Smith, Ella S., McKay, Alannah K. A., Ackerman, Kathryn E., Harris, Rachel, Elliott-Sale, Kirsty J., Stellingwerff, Trent and Burke, Louise M.. (2022). Methodology review : A protocol to audit the representation of female athletes in sports science and sports medicine research. International Journal of Sport Nutrition and Exercise Metabolism. 32(2), pp. 114-127. https://doi.org/10.1123/ijsnem.2021-0257

Defining training and performance caliber : A participant classification framework

McKay, Alannah K. A., Stellingwerff, Trent, Smith, Ella S., Martin, David T., Mujika, Iñigo, Goosey-Tolfrey, Vicky L., Sheppard, Jeremy and Burke, Louise M.. (2022). Defining training and performance caliber : A participant classification framework. International Journal of Sports Physiology and Performance. 17(2), pp. 317-331. https://doi.org/10.1123/ijspp.2021-0451

Exercise and heat stress : Inflammation and the iron regulatory response

McKay, Alannah K. A., McCormick, Rachel, Tee, Nicolin and Peeling, Peter. (2021). Exercise and heat stress : Inflammation and the iron regulatory response. International Journal of Sport Nutrition and Exercise Metabolism. 31(6), pp. 460-465. https://doi.org/10.1123/ijsnem.2021-0080

Neither beetroot juice supplementation nor increased carbohydrate oxidation enhance economy of prolonged exercise in elite race walkers

Burke, Louise M., Hall, Rebecca, Heikura, Ida A., Ross, Megan L., Tee, Nicolin, Kent, Georgina L., Whitfield, Jamie, Forbes, Sara F., Sharma, Avish P., Jones, Andrew M., Peeling, Peter, Blackwell, Jamie R., Mujika, Iñigo, Mackay, Karen, Kozior, Marta, Vallance, Brent and McKay, Alannah K. A.. (2021). Neither beetroot juice supplementation nor increased carbohydrate oxidation enhance economy of prolonged exercise in elite race walkers. Nutrients. 13(8), p. Article 2767. https://doi.org/10.3390/nu13082767

The validity of ultrasound technology in providing an indirect estimate of muscle glycogen concentrations is equivocal

Bone, Julia L., Ross, Megan L., Tomcik, Kristyen A., Jeacocke, Nikki A., McKay, Alannah K. A. and Burke, Louise M.. (2021). The validity of ultrasound technology in providing an indirect estimate of muscle glycogen concentrations is equivocal. Nutrients. 13(7), p. Article 2371. https://doi.org/10.3390/nu13072371

Acute ketogenic diet and ketone ester supplementation impairs race walk performance

Whitfield, Jamie, Burke, Louise M., McKay, Alannah K. A., Heikura, Ida A., Hall, Rebecca, Fensham, Nikita and Sharma, Avish P.. (2021). Acute ketogenic diet and ketone ester supplementation impairs race walk performance. Medicine and Science in Sports and Exercise. 53(4), pp. 776-784. https://doi.org/10.1249/MSS.0000000000002517

Sustained Exposure to High Carbohydrate Availability Does Not Influence Iron-Regulatory Responses in Elite Endurance Athletes

McKay, A., Peeling, P., Pyne, D.B., Tee, N., Welveart, M., Heikura, I., Sharma, A.P., Whitfield, J., Ross, M., van Swelm, R.P.L., Laarakkers, C.M. and Burke, L.. (2021). Sustained Exposure to High Carbohydrate Availability Does Not Influence Iron-Regulatory Responses in Elite Endurance Athletes. International Journal of Sport Nutrition and Exercise Metabolism. 31(2), pp. 101-108. https://doi.org/10.1123/ijsnem.2020-0224

Adaptation to Low Carbohydrate High Fat diet is rapid but impairs endurance exercise metabolism and performance despite enhanced glycogen availability

Burke, Louise M., Whitfield, Jamie, Heikura, Ida A., Ross, Megan L. R., Tee, Nicolin, Forbes, Sara F., Hall, Rebecca, McKay, Alannah K. A., Wallett, Alice M. and Sharma, Avish P.. (2021). Adaptation to Low Carbohydrate High Fat diet is rapid but impairs endurance exercise metabolism and performance despite enhanced glycogen availability. Journal of Physiology. 599(3), pp. 771-790. https://doi.org/10.1113/JP280221

Iron metabolism : Interactions with energy and carbohydrate availability

McKay, Alannah K. A., Pyne, David B., Burke, Louise M. and Peeling, Peter. (2020). Iron metabolism : Interactions with energy and carbohydrate availability. Nutrients. 12(12), p. 3692. https://doi.org/10.3390/nu12123692

Examining the decay in serum ferritin following intravenous iron infusion : A retrospective cohort analysis of Olympic sport female athletes

McKay, Alannah K. A., Goods, Paul S. R., Binnie, Martyn J., Goodman, Carmel and Peeling, Peter. (2020). Examining the decay in serum ferritin following intravenous iron infusion : A retrospective cohort analysis of Olympic sport female athletes. Applied Physiology, Nutrition and Metabolism. 45(10), pp. 1174-1177. https://doi.org/10.1139/apnm-2020-0132

Topical sodium bicarbonate : No improvement in blood buffering capacity or exercise performance

McKay, Alannah K. A., Peeling, Peter, Binnie, Martyn J., Goods, Paul S. R., Sim, Marc, Cross, Rebecca and Siegler, Jason. (2020). Topical sodium bicarbonate : No improvement in blood buffering capacity or exercise performance. International Journal of Sports Physiology and Performance. 15(7), pp. 1005-1011. https://doi.org/10.1123/ijspp.2019-0345

Validity and reliability evidence of a point of care assessment of salivary cortisol and a-amylase: a pre-registered study

Kagan J. Ducker, Robin L.J. Lines, Michael T. Chapman, Peter Peeling, Alannah K.A. McKay and Daniel F. Gucciardi. (2020). Validity and reliability evidence of a point of care assessment of salivary cortisol and a-amylase: a pre-registered study. PeerJ. 8(e8366). https://doi.org/10.7717/peerj.8366

Crisis of confidence averted : Impairment of exercise economy and performance in elite race walkers by ketogenic low carbohydrate, high fat (LCHF) diet is reproducible

Burke, Louise M., Sharma, Avish P., Heikura, Ida A., Forbes, Sara F., Holloway, Melissa, McKay, Alannah K. A., Bone, Julia L., Leckey, Jill J., Welvaert, Marijke and Ross, Megan L.. (2020). Crisis of confidence averted : Impairment of exercise economy and performance in elite race walkers by ketogenic low carbohydrate, high fat (LCHF) diet is reproducible. PLoS ONE. 15(6), pp. 1-31. https://doi.org/10.1371/journal.pone.0234027

Iron considerations for the athlete : A narrative review

Marc Sim, Garvican-Lewis, Laura A., Cox, Gregory R., Govus, Andrew D., McKay, Alannah K. A., Stellingwerff, T. and Peeling, Peter. (2019). Iron considerations for the athlete : A narrative review. European Journal of Applied Physiology. 119(7), pp. 1463-1478. https://doi.org/10.1007/s00421-019-04157-y