Variations in iron status with fatigue modelled from training in female distance runners

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Abstract
A low hemoglobin level or even frank anemia is common among female endurance runners; controversy presently exists on the effectiveness of iron supplementation. In the past inadequate descriptions of training and too infrequent measurement of iron indices over a sufficiently long period, have made it difficult to establish any relationship between iron status and training upon which to base a rational iron therapy. In this study 5 young women distance runners age 18–25 years have been studied for 300 days. A numerical index was used to quantify the extent of an individual's daily training effort and a conceptual model of the effect of training allowed definition of the extent of consequent fatigue, to be calculated. Red blood cell number and hemoglobin concentration were measured regularly throughout, and during the last 200 days serum iron, ferritin, total iron binding capacity and percent transferrin saturation were also measured. It has been shown in most subjects that serum iron and transferrin saturation varied in phase with training and the fatigue index, throughout the period while serum ferritin varied out of phase. It is suggested that supplementing iron intake may be of little use during heavy training and concomitant high fatigue because transferrin saturation is also very high at this time and ineffective in promoting absorption of dietary iron.