Iron Basics

Athletes are notorious for having low iron levels, especially endurance athletes. But what if your ferritin is high? Although it’s not nearly as common, it does happen and it’s important to have your ferritin levels checked periodically to make sure you’re not too high or low, both of which can be problematic. Here’s the quick and clean on what you need to know about high ferritin as an athlete.

Food containing natural iron. Fe: Liver, avocado, broccoli, spinach, parsley, beans, and nuts.

Before we dive into the details on ferritin, let’s cover some basics. Ferritin is the stored form of iron. Your body doesn’t like a lot of free iron because it can oxidize, it’s highly reactive, so it keeps most of it in storage AKA ferritin. Athletes need adequate ferritin levels for optimal athletic performance. This is your body’s iron supply which helps deliver fresh oxygen to your working muscles and waste products out of the tissue during exercise. 

Why do some athletes have high iron?

The truth is, anyone can have high ferritin levels. If you search for causes of high ferritin levels, be prepared to freak out. Medical causes include infection, liver disease, rheumatoid arthritis, hyperthyroidism, or the catch all- cancer. Before you freak out and start writing your will, know that almost all athletes have high ferritin for none of these reasons.

So no, you’re probably not dying. You likely fall into one of two categories 1) genetics or 2) supplements. 

The most common reason for high ferritin is a genetic predisposition to a high affinity for iron. This just means your body is more likely to absorb iron and have higher levels. I’ve seen many athletes who don’t eat tons of iron-rich foods and aren’t taking an iron supplement who have high ferritin levels. If you’re interested in finding out if you have a high affinity for iron, you can take a genetic test with a simple cheek swab that’s mailed to your home. 

Just because you have a high affinity for iron doesn’t mean you will have iron levels. Yours truly has a high affinity for iron, but when I had my blood tested (you can get both the genetic and blood test with the platinum panel) my iron levels were optimal. So basically you can still have low iron levels with a high affinity for iron, which is why periodic blood testing is important. 

The second most common reason for high ferritin levels is iron supplementation. This isn’t quite as common because your body’s so wicked smart. As your ferritin rises and your body doesn’t need as much iron, you absorb less. But even with this natural mechanism in place, it’s still possible to get too much iron. 

What happens when ferritin is high?

Interestingly, many of the symptoms of low ferritin are similar to high ferritin. This can be problematic because some athletes think they’re low in iron (more likely) so they start taking iron supplements and it actually makes the problem worse because they were high in iron. Symptoms of high ferritin include:

  • Fatigue/exhaustion
  • Joint pain
  • Low libido 
  • Loss of body hair
  • Stomach & abdominal pain
Athlete resting

What athletes can do about high iron?

If you get your blood tested and you have high ferritin there are some things you can do to help get it to a healthy level. 

Avoid supplemental iron

Stop any iron supplements and check your multivitamin (if you take one) for iron.

Avoid cast iron cookware 

Cast iron actually increases the iron content of food, so use some other type of cookware (literally anything else besides cast iron). 

Opt for plant proteins

Plant foods contain non-heme iron, which isn’t absorbed as well so it is less likely to increase your iron levels. Avoid or reduce your intake of red meat, dark meat poultry like chicken thighs, and seafood, which all contain larger amounts of iron.

Get some calcium, coffee, or tea with your meals

Athletes should be consuming plenty of calcium anyways, but having a calcium-rich beverage like fortified almond milk can reduce iron absorption. The same goes for coffee and tea. The tannins bind to the iron so less is absorbed. 

Keep training

Your body will use the iron as you train, so if you feel able, keep doing your workouts. This will help lower your ferritin as your training demands pull from the pool of stored iron. If you are too fatigued for high ferritin levels, talk to your doctor. 

Iron is a tricky mineral yet it’s crucial for health and performance. It’s important to have iron levels checked every few months (ideally) or at least once a year to make sure you are within an ideal range for health and athletic performance.

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