Signs of Iron Deficiency

Your fatigue might mean more than just a lack of sleep.

By Danielle Zickl, Runner's World

As a runner, there are a lot of vitamins and minerals your body needs to function and perform at your best. One of the most important—and often overlooked—ones? Iron.

That’s because this mineral makes it possible for red blood cells to carry oxygen to your muscles to power them, which is “especially critical during exercise,” according to Nathan Myers, M.S., R.D., C.D.N., clinical dietitian at James J. Peters VA Medical Center in New York.

Iron also plays a role in helping you metabolize carbs, which are your muscles’ primary source of fuel during high-intensity activity, like a track workout. “Without adequate iron, a runner will become fatigued much more easily and recover slower as well,” Myers says.

And according to Guillem Gonzalez-Lomas, M.D., an orthopedic surgeon at NYU Langone’s Sports Medicine Center, training when you’re low on iron can lead to inflammation, which can trigger the release of a molecule called hepcidin from the liver. “Hepcidin sequesters the iron and prevents it from being used by the body, lowering the functional deficit even further,” he says.

Not sure if you’re getting enough iron? Here are four signs to look out for that might be pointing to a deficiency, plus what you can do to boost your intake.



1

You’re always tired

If you know you’re getting enough sleep but you feel insanely tired all the time, you might be low on iron. It all circles back to iron’s role in helping your blood carry oxygen efficiently, Myers explains.

“There won’t be enough iron for your red blood cells to transport oxygen or carry away carbon dioxide,” he says. “Thus, fresh oxygen is delivered and waste is removed more slowly, resulting in a feeling of fatigue.”

This can hamper exercise performance, warns Gonzalez-Lomas—and not just because you feel zonked before your workout even starts. “An iron deficiency increases muscle fatigue and worsens your endurance and aerobic capacity,” he says, which are two things that are essential for runners.



2

Your skin is paler than normal

If you’ve noticed that your skin is looking more pale than usual, this is another possible signal that you aren’t getting enough iron in your diet. The more iron you get, the more color you’ll have in your complexion.

“Iron gives hemoglobin [a protein in red blood cells that carries oxygen] its red color, which in turn gives color to the skin. As the red color decreases due to lack of iron, the skin appears more pale,” says Myers.

And it’s not just about your skin, either. If you’re lacking iron, you might also notice paleness in your gums or your nails, too.



3

Your extremities are cold

Fingers and toes constantly freezing? If you don’t get enough iron, your body experiences reduced oxygenation of your blood. As a result, it pulls blood away from your extremities and instead sends it to more essential organs, such as your brain, heart, kidneys, liver, and lungs, Myers says. Less blood flow to your fingers and toes means they’ll feel colder.



4

Your heart rate is unusually high

The average person has a resting heart rate that’s between 60 and 100 beats per minute (bpm). However, athletes like runners tend to have a lower resting heart rate—usually somewhere between 40 and 60 bpm. (This is because the hearts of people who are more fit don’t have to work as hard—and beat as fast—to pump blood.)

Knowing what your resting heart rate is can come in handy for a few reasons: It can clue you in on if you’re getting sick, overtraining, or stressed out. It can also tell you if you have an iron deficiency.

Because your body senses that less oxygenated blood is available and waste is building up, your heart rate speeds up to be able to pump the available oxygenated blood more rapidly to meet your body’s needs, according to Myers. The more oxygenated blood that’s available, the less waste buildup there is, and your heart doesn’t have to do any extra work.

Find out if you’re iron deficient

If you have any of the above signs, you may want to check with a doctor. He or she may recommend a blood test to check if you’re actually iron-deficient and have iron deficiency anemia, a condition in which your body doesn’t have enough iron to make a part of your red blood cells called hemoglobin, according to the Mayo Clinic.

If you are, your doctor may recommend things like eating iron-rich foods or undergoing further testing like a colonoscopy to check for other possible causes of iron deficiency, like blood loss caused by gastrointestinal bleeding.

How to get more iron in your diet

Foods like clams, red meat, oysters, eggs, salmon, tofu, raisins, whole grains, spinach, and legumes are all good sources of iron, according to Myers, so making them a regular part of your diet is definitely the way to go. He advises against taking iron supplements—especially without a doctor’s recommendation—since they can sometimes cause GI distress, including stomach cramps and constipation.

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The average person needs about 8 milligrams (mg) of iron per day, Myers says. But women who are menstruating need 18 mg per day to make up for loss of blood.

Just be aware that iron can be tough for your body to absorb, according to Myers. Iron absorption can be inhibited by compounds called phytates, commonly found in legumes, rice, and grains, says Gonzalez-Lomas. Both Myers and Gonzalez-Lomas agree that the trick to improve your body’s ability to absorb iron is to combine any iron-rich food you eat with vitamin C, which helps your body break it down. Cooking acidic foods in cast iron cookware can also help.