Iron Deficiency in Endurance Athletes: Signs, Testing & Treatment Ep 150

2 Jul 2026 · 39 min
38:35

In this episode of the Find Your Edge podcast, host Chris Newport hands the conversation over to graduate student Emily Q, who interviews exercise scientist Dr. Corey Dugan about iron deficiency in endurance athletes, with a focus on adolescent female athletes. Dr. Dugan explains how endurance exercise creates iron loss through gastrointestinal bleeding, sweat, and foot‑strike hemolysis, and how the inflammation‑driven hormone hepcidin blocks iron absorption after training. He adds female‑specific stressors—menstruation and adolescent growth— that further increase iron demand. The discussion moves to the vague, non‑specific symptoms (fatigue, brain fog, restless‑leg‑like sensations, sleep issues, heart palpitations, pica, etc.) that make the condition hard to recognize. Dr. Dugan critiques standard blood panels, emphasizing the need for iron‑specific biomarkers (ferritin, transferrin saturation, total iron‑binding capacity) and warns that normal hemoglobin can mask early deficiency. He outlines the ongoing debate over optimal ferritin thresholds (WHO <15 µg/L, Australian <30 µg/L, newer research suggesting functional cut‑offs of 25–50 µg/L) and stresses the importance of longitudinal monitoring rather than single measurements. Screening frequency recommendations (at least twice a year) and emerging non‑invasive tools are mentioned. For treatment, he differentiates dietary strategies, oral iron supplementation (ferrous sulfate vs. bisglycinate), timing (avoid post‑exercise, vitamin C co‑ingestion, avoid calcium, coffee, tea), and dosing frequency (every‑other‑day dosing to mitigate hepcidin‑induced absorption block and GI side effects). Intravenous iron is presented as an option for iron‑deficiency anemia, with a note on WADA’s ban on infusions >100 mL/12 h without exemption. The conversation also touches on alternative iron sources (heme from animal foods, cast‑iron cooking, Lucky Iron Fish) and concludes with a warning about social‑media misinformation and the need for evidence‑based guidance.

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