Abstract
A high prevalence of iron deficiency exists in athlete populations. Various
mechanisms, including increased losses through sweat, haemolysis, haematuria,
and gastrointestinal micro-ischemia; inadequate dietary intake; and transient
exercise-induced increases in the regulatory hormone, hepcidin, contribute to
the increased prevalence in athletes. Indeed, hepcidin has been shown to peak
around 3–6 hours post-exercise, limiting iron absorption from
the gut. As the practitioner’s ability to control losses is limited, the
key to treatment of iron deficiency in athletes is optimal timing of dietary and
oral iron supplementation around these periods of reduced gut absorption. While
timing and dosing schedule strategies might be sufficient to treat iron
deficiency non-anaemia, the significant lag to impact iron status is relatively
long. Therefore, in iron deficiency anaemia, the use of parenteral iron has the
benefit of rapid repletion of iron stores and normalisation of haemoglobin
status, while bypassing the action of hepcidin at the gut. Furthermore, newer
intravenous formulations can be administered as a single total dose over
15–60 min and have a similar safety profile to oral treatment.
This review discusses the existing evidence for parenteral iron use in athletes
and the unique context for consideration when choosing the parenteral route in
this population.
Key words
iron supplement - intravenous iron - athlete - nutrient deficiency
