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Iron Deficiency in Adolescent Female Athletes—Is Iron Status Affected by Regular Sporting Activity?

Sandström, Göran MD*; Börjesson, Mats MD, PhD; Rödjer, Stig MD, PhD

Clinical Journal of Sport Medicine: November 2012 - Volume 22 - Issue 6 - p 495–500
doi: 10.1097/JSM.0b013e3182639522
Original Research

Objective: To determine the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) among a group of female athletes and compare with an age-matched group of female nonathletes. To study lifestyle factors that could play a role in the development of ID and IDA and compare these factors between the groups.

Design: A controlled clinical trial.

Setting: A senior high school for athletes in Gothenburg, Sweden.

Participants: All female athletes at a senior high school for top-level athletes were offered to take part. Fifty-seven female athletes accepted to participate in the study. The control group consisted of a random sample of 130 age-matched nonathlete students; 92 accepted to participate in the study.

Intervention: Intervention was not an actual part of this study but those with ID and IDA were treated with iron by the regular school doctor.

Main Outcome Measures: Iron deficiency anemia and ID were determined by levels of hemoglobin, serum iron, total iron-binding capacity, transferrin saturation, and serum ferritin.

Results: The main result of the study is the finding that ID and IDA are common among young adolescent female athletes and that there was no difference between female athletes and nonathletes. In the athlete group, 30 of 57 individuals (52%) had ID compared with 43 of 92 individuals (48%) in the nonathlete group (P > 0.3). Comparisons of the 2 groups showed no significant difference in hemoglobin (P > 0.30). In total, we found that 5 of 57 athletes (8.6%) had IDA compared with 3 of 92 nonathletes (3.3%), the difference being not statistically significant (P = 0.24).

Conclusions: The main finding of this study is that ID and IDA are common among female adolescents but not more common among athletes than nonathletes. The results are despite factors that should favor a better iron status in the athlete group, such as better iron intake and less menstrual bleeding. Other factors that might have an impact on iron balance, must therefore be considered.

*Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden

Department of Acute and Cardiovascular Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

Section of Hematology and Coagulation, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.

Corresponding Author: Göran Sandström, MD, Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Smörslottsgatan 1, SE 416 85 Gothenburg, Sweden (

Supported by grants from The Swedish National Centre for Research in Sports and The Göteborg Medical Society.

The authors report no conflicts of interest.

Received January 17, 2012

Accepted June 7, 2012

© 2012 Lippincott Williams & Wilkins, Inc.