Colleges Fall Short in Testing for Iron Deficiencies

By Staff

Coaching Management, 12.11, November 2004,

Iron deficiency affects 60 percent of female athletes in the United States, according to The Centers for Disease Control and Prevention. And a new study has found that most NCAA Division I institutions have a ways to go in detecting and treating the condition.

An anonymous online survey was sent to 94 NCAA Division I-A schools to determine current practices in screening and treating athletes for iron deficiency. Only 43 percent of the 54 respondents indicated that their institutions screened for iron deficiency in female athletes.

"We found that there really wasnít anything consistent," says Chris Rosenbloom, Nutrition Consultant for the Georgia Tech athletic department, Associate Professor at Georgia State University, and one of the studyís authors. "A lot of schools werenít testing, and of those that were testing, some were just testing freshmen and some were testing but not following up. In addition, different schools were using different cutoff values for what they defined as anemia."

Rosenbloom believes all athletes should be tested at least once a year. "And it would be wise not to do just hemoglobin and hematocrit tests, but also to look at their iron and ferritin levels," she says. "One of the misconceptions is that, ĎWell, I had a finger stick and my hemoglobin was okay, therefore Iím fine,í but sometimes, the athlete really isnít fine."

Female athletes are particularly at risk, says Rosenbloom, because they usually are more restrictive with their diets and may not eat enough iron-rich foods. "A lot of female athletes are vegetarian or semi-vegetarian," she says, "which cuts out a lot of good iron sources."

Another common misconception among athletes is that because iron is found in grains, breads, and cereals, those sources alone provide adequate amounts to satisfy a vegetarian diet. "You have to make sure that if you are eating iron-fortified grains, you are also getting a good vitamin C source to help with absorption," says Rosenbloom. "There are things that an athlete can do to make a vegetarian diet work, but itís harder to get adequate iron if you donít eat meat."

Rosenbloom notes that all athletes lose some iron in sweat. And when athletes take a lot of over-the-counter anti-inflammatory medications like ibuprofen or aspirin, those drugs can cause minor gastrointestinal blood loss. "When you add those things up, you can easily have an athlete who has iron deficiency anemia or iron deficiency without anemia," she explains.

There are also some misconceptions that iron supplements are a cure-all. "My philosophy is that if you know someone is already iron-depleted, have them take iron supplements to prevent a true deficiency, and of course add food sources high in iron into their diets," says Rosenbloom. "But coaches and athletic trainers should avoid promising the athlete that just because they take an iron supplement, they are going to dramatically improve their performance right away. Iron deficiency does not occur overnight, and the remedies also take time."

For more information on iron deficiencies visit the Iron Disorders Institute at or The Centers for Disease Control at and enter "iron deficiency" in the search window. To read an article on nutrition for vegetarian athletes, go to and enter "vegetarian" into the search window.