Parenteral iron therapy: Examining current evidence for use in athletes
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 form 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.
RAS ID
62203
Document Type
Journal Article
Date of Publication
1-1-2023
Volume
45
Issue
7
Funding Information
Royal Perth Hospital Research Foundation Fellowship / Emerging Leader Fellowship / Western Australian Future Health Research and Innovation Fund
School
School of Medical and Health Sciences
Copyright
free_to_read
Publisher
Thieme
Comments
Fensham, N., McKay, A. K. A., Sim, M., & Peeling, P. (2023). Parenteral iron therapy: Examining current evidence for use in athletes. International Journal of Sports Medicine, 45(7), 496-503. https://doi.org/10.1055/a-2211-0813