COULD YOUR
TIRED CLIENT BE
IRON DEFICIENT?
If clients are tired, breathless and unable to sustain activity before they
even start training with you, they may be lacking in one critical mineral.
WORDS: GLORIA CABRERA
ver been so tired that going about
your daily activities seems like a
chore? Imagine feeling like this all
the time and then trying to keep up an
intense training routine. Could the reason for
feeling like this be iron deficiency? As a
female vegetarian with a good training
routine, I know the feelings of iron deficiency
all too well. You have every intention of
training, but you’re so tired that even the
thought of driving to the gym is exhausting…
Iron deficiency can be one of the causes of
ongoing fatigue and impaired performance.
Prolonged iron deficiency can also lead to
anaemia, a condition defined by a deficiency
in the number and quality of red blood
cells. Common symptoms of iron deficiency
include a lack of energy or weakness,
irritability, inability to concentrate, shortness
of breath, paleness, dizziness and even
bizarre cravings to eat things as strange as
ice or dirt (more common in iron deficient
pregnant women than in the average gym
goer).
As a PT you are not trained to diagnose
iron deficiency, but being aware of the
symptoms, understanding a bit more about
it, and knowing which clients are at greater
risk is useful – and may help explain what is
hindering your client’s progress.
E
What is iron and how does
deficiency affect exercise
performance?
Iron is a trace mineral. The body cannot make
it, so we need to consume it in food. Iron is
involved in numerous bodily processes,
including oxygen transportation, enzyme
reactions and immune system function,
among others.
During exercise, having sufficient energy
and the ability to breathe properly greatly
24 | NETWORK SUMMER 2016
impacts performance, and therefore the
desire to continue training. Although
there are several reasons for feeling
tired or breathless, such as insufficient
rest, dehydration and poor nutrition, iron
deficiency is another potential cause.
So why does a lack of iron have this effect?
The body uses red blood cells to transport
oxygen to and from our lungs, to our cells
and to remove carbon dioxide. Iron is used
to produce these red blood cells, and is also
involved in the oxygen transport process.
Red blood cells contain an oxygen transport
protein called haemoglobin, in which up to
four iron molecules are embedded (muscles
have another oxygen transport protein called
myglobin which receives oxygen from the
haemoglobin). Iron not only gives red blood
cells their red colour, but also serves the
important purpose of binding oxygen. Once
oxygen is bound, it can be taken to and from
our lungs to our body and muscle cells. Once
oxygen is delivered, the iron binds to the
waste product, carbon dioxide, taking it back
to the lungs to then be exhaled. Iron’s role in
energy and breathing, therefore, is critical.
And why is getting enough oxygen so
important? You need a constant supply
of oxygen and glucose to produce the
energy your body needs to keep your heart
pumping, lungs inhaling and exhaling, and
cells, muscles and organs functioning.
Exercise increases the metabolic rate and
energy needs of muscles. The more you
move, the more energy you require and thus
more of the energy molecule ATP (adenosine
triphosphate) must be produced, which
requires more glucose and oxygen. If you
don’t have enough iron, then less oxygen will
circulate around your body and be delivered
to your cells to produce the needed ATP,
leaving you tired, breathless and unable to
sustain activity.
Who is likely to get iron
deficiency?
Iron deficiency can occur in both men
and women, but is more common in the
following clients:
• Women of child-bearing age who
menstruate and lose blood each month
• Those who follow vegetarian and vegan
diets or who do not eat much meat. Meat,
especially red meat, is an easy way to get
iron, so those who avoid it need a
well-planned diet containing sufficient iron.
• Those with a poor diet which is low in
iron and other nutrients.
• Those on kilojoule-restricted or high
carbohydrate diets. Clients who train for
weight loss often also restrict their
energy intake, inadvertently restricting
the amount of nutrients, like iron, that
they consume. Others may have high
carbohydrate intakes to fuel activity but
neglect other nutrient or iron rich foods.
• Athletes or clients who train intensely can
deplete iron stores in a number of ways.
Firstly, intense activity may stimulate an
increase in the number of red blood cells
and small blood vessels, thus increasing
the demand for iron, especially during
periods of growth. Iron is also lost through
sweat, and through gastrointestinal
bleeding, which commonly occurs during
strenuous exercise due to minor damage
to the stomach and intestinal lining.
Through repeatedly pounding their feet on
hard surfaces, runners may be more prone
to footstrike haemolysis, which can
destroy red blood cells.
How much iron is needed and
which foods contain it?
Iron requirements depend on age and
gender. Adult females aged 19 to 50 require