Iron Deficiency in Distance Runners A Reinvestigation Using 59Fe-Labelling and Non-Invasive Liver Iron Quantification

In a group of male distance runners, 23 out of 45 athletes showed decreased serum ferritin values (< 35 μg/l). The high prevalence of a typical iron deficiency in runners was confirmed in a subgroup of eight athletes in which the iron metabolism was studied in detail using radio-iron labelling and liver iron quantification. Most of these athletes showed an up-regulat:ed 59Fe absorption and a decreased liver iron concentration as compared to a control group. ⁵⁹Fe activity in collected samples of stool, urine or sweat was measured sensitively using a shielded high-pure germanium spectrometer. In periods without running, a faecal excretion of ⁵⁹Fe equivalent to 1.5 ml blood loss/d was; observed, which represents the normal iron excretion. Under intensive training or racing conditions, a significant increase up to 4.9-6.6 ml blood loss/day was observed, whereas excretiom of ⁵⁹Fe in urine or sweat was negligible. Thus, gastrointestinal blood loss was the main reason for the slightly negative iron balance in the runners. This confirms earlier studies in the literature using qualitative blood stool testing. A treatment with 100 μg ferrous iron/day for 3 months significantly increased the values for serum ferritin (from 34 ± 11 to 54 +18 μg/l) and liver iron (from 105 ± 42 to 227 ± 67 μg/g liver).

Key words

Runners - iron deficiency - 59Fe absorptiom test - liver iron - gastrointestinal blood loss