What is “sports” or “athletic anemia” and how can it be prevented?

“Sports anaemia” occurs when trained athletes experience low levels of blood haemoglobin (normal levels are to 14-17.5 g/dl for men and 12-16 g/dl for women), as well as low haematocrit and low ferritin levels [1,2,3]. Some factors that may cause this kind of anaemia are [6,5]:

1. Inadequate iron intake
2. Poor iron absorption
3. Loss of iron through sweat
4. Destruction of red blood cells
5. Gastrointestinal blood loss
6. Loss through urine

“Sports anaemia” is connected with an increase in red blood cell destruction and a decrease concentration of hemoglobin occurring mostly at the beginning of a strenuous conditioning program. This kind of anaemia used to be called “March hemoglobinuria”. [1,3]

It’s a haemolysis, or rupture caused by repeated compression of red blood cells in the capillary vessels on the side of the leg when the foot impacts the ground. It used to be very common, apart from athletes and marathon runners, in soldiers going long marches. [1,3]

“Sports anaemia” can also be caused by an inadequate protein intake especially in the early stages of training. The demand to form additional muscle tissue may compete with the demand to form additional hemoglobin, thus causing the anemia. [1,3]

The resulting decrease in blood gas transport and muscle enzyme activity impairs performance. This is the reason why people and especially athletes have to have a blood test with a full blood count to prevent or quickly correct low hemoglobin and iron levels.

The best way to tackle “sports anaemia” is prevention. It can be prevented through proper nutrition that includes all the necessary ingredients, vitamins and minerals. People who exercise must have a high protein diet with a high iron content. Foods that are good sources of protein and iron are red meats, poultry (the dark parts of chicken have higher iron levels than the white parts), fish, and eggs. Special attention must be given to high intakes of tea and coffee because they can decrease iron absorption. Also, wine and vinegar can reduce iron absorption so it is better not to combine them with your meals. Some medications also reduce iron absorption, for example, tetracycline and antacids [1]. Eat food or beverages high in vitamin C together with an iron rich meal or iron supplements to enhance iron absorption, for example, orange juice. Remember that the iron in meat (called ‘heme iron’) is better absorbed than non-heme iron found in vegetables, fruit, beans and whole grains.

Finally, there are a lot of iron supplements available on the market, although these must be taken only in diagnosed conditions of iron deficiency. Self-medicating, generally, should be discouraged because of intolerance, risk of overdose and many other drug interactions.

Writer: Antonia Georgiou: B.Sc. Nutrition and Dietetics, B.Sc. General Nursing, Dipl. Instructor Fitness, diploma: Initiative and entrepreneurship.