Int J Sports Med 2024; 45(07): 496-503
DOI: 10.1055/a-2211-0813
Review

Parenteral Iron Therapy: Examining Current Evidence for Use in Athletes

Nikita Fensham
1   Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
,
Alannah Kelly Anne McKay
1   Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
,
Marc Sim
2   School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
3   Medical School, The University of Western Australia, Perth, Australia
,
Peter Peeling
4   School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Australia
5   Western Australian Institute of Sport, Mt Claremont, Australia
› Author Affiliations

Abstract

A high prevalence of iron deficiency exists in athlete populations. Various mechanisms, including increased losses through sweat, haemolysis, haematuria, and gastrointestinal micro-ischemia; inadequate dietary intake; and transient exercise-induced increases in the regulatory hormone, hepcidin, contribute to the increased prevalence in athletes. Indeed, hepcidin has been shown to peak around 3–6 hours post-exercise, limiting iron absorption from the gut. As the practitioner’s ability to control losses is limited, the key to treatment of iron deficiency in athletes is optimal timing of dietary and oral iron supplementation around these periods of reduced gut absorption. While timing and dosing schedule strategies might be sufficient to treat iron deficiency non-anaemia, the significant lag to impact iron status is relatively long. Therefore, in iron deficiency anaemia, the use of parenteral iron has the benefit of rapid repletion of iron stores and normalisation of haemoglobin status, while bypassing the action of hepcidin at the gut. Furthermore, newer intravenous formulations can be administered as a single total dose over 15–60 min and have a similar safety profile to oral treatment. This review discusses the existing evidence for parenteral iron use in athletes and the unique context for consideration when choosing the parenteral route in this population.



Publication History

Received: 31 August 2023

Accepted: 13 November 2023

Accepted Manuscript online:
14 November 2023

Article published online:
22 December 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany