Anemia in Swimmers: Fact or Fiction? Study of Hematologic and Iron Status in Male and Female Top-level Swimmers*

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Abstract
The aim of the project was to examine the hematologic and iron status of a group of top-level male and female swimmers compared with a control group composed of fit, physically active subjects. The following parameters were examined: red blood cells (RBC), hemoglobin concentration (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), serum iron (S I), total iron-binding capacity (TIBC), transferrin saturation (Sat), and serum ferritin concentration (S F). The male swimmers had higher values than the control men for RBC (5364 vs. 5163, P <.01), Hb (15.4 vs 14.8, P<.01), Hct (49 vs 46.6, P<.01), TIBC (341 vs 297, P<.001), and S I (107 vs 86.3, P<.01). The female swimmers had higher values than the control women for MCV (91.2 vs 88.5, P<.01), Hb (14 vs 12.8, P<.01), Hct (44.2 vs 40.4, P<.001), S F (58.65 vs 42.17, P<.01), S I (106 vs 75.6, P<.01), and TIBC (336 vs 278, P<.001). The differences between men and women were smaller between the men and women of the swimmers group with respect to the men and women of the control group, for Hb: 15.4 vs 14 (P<.01) and 14.8 vs 12.8 (P<.001) and S F: 97.24 vs 58.65 (P<.001) and 99.89 vs 42.17 (P<.001). Our results show that the male swimmers had a greater iron pool than the control men and the female swimmers a greater pool than the control women, even if it is less than the desired level. Excellence in aerobic sports activities presupposes therefore an increased iron pool.