Iron levels and fatigue

Nice to be able to put a number on a few months of unexplained fatigue! Blood tests show decreased (fortunately not yet depleted) iron stores… Aligns very well with feelings of slugginess and delayed recovery, (shorter) training performance in itself still being perfectly okay but an inability to push in extreme environments in my last race (NOT trying to find excuses!).

Iron deficiency or low Hb is not uncommon in (female) athletes! Depending on which value you look at, 10-15% of female athletes is thought to have low Hb or low iron stores – and that is by the strictest measures of depleted iron stores. Fatigue, though a difficult topic for objective studies, seems to set in before that.


Your doctor often only checks for hemoglobin levels, but ask them to check for other iron-related values, too. Ferritin is a good one, indicating iron stores. Your Hb can be normal but the stores are being depleted to keep this Hb level up and there are indications that this explains fatigue.

Also, it’s great if this can be done in a non-fatigued state as well, because it gives a baseline level, an ‘individual’ value. Normal for the general population can be low for an elite athlete, who by definition is not ‘normal’ and can, by natural selection, have high Hb values. A low-to-normal value will not raise a flag at the doctor’s office, but can be very far from normal for you.

Oh yes and of course I have had a long training season. After a totally exhausting Motala race I had to try to qualify for Maui only 2 weeks after that. Four weeks after that I raced in Czech Republic. After that I couldn’t hold back and we biked a lot the week after that. I wasn’t entirely recovered before Zell am See. The million dollar question is ‘what is cause, what is consequence’ – was I underrecovered because of low iron or was it the training load, would I have been able to handle the load better with healthy iron status? -  but that doesn’t matter when it comes to recovery, then it’s rest that counts.

That said, I will race Malmö Höstmilen this weekend :D (after 10 days of rest and easy training, mind you!)

PS Excess iron supplementation does more harm than good so if you feel healthy and eat red meat regularly, check with your doctor before taking supplementation!