Is it possible to train with low hemoglobin. Iron deficiency anemia in athletes! Why is it difficult to exercise with anemia?

Defined by low levels of iron in the blood, iron deficiency occurs in approximately 50 percent of female athletes and is slightly less common in men. Left untreated, iron deficiency can develop into iron deficiency anemia (IDA), which impairs the body's aerobic processes, brain and muscle metabolism, impairs performance and endurance, and weakens the immune system.

Iron is a key element in aerobic exercise and directly affects the performance of an athlete, it is an element that is responsible for the production of hemoglobin and myoglobin. Its main function is to carry oxygen from the lungs to the tissues, and it carries carbon dioxide from the tissues to the lungs. It also retains and stores oxygen in your muscles to keep them active when you swim, pedal, run, or just go shopping. Without iron, oxygen entering the body is useless. Simply put, when iron levels are too low, your ability to move actively, and sometimes just move, is drastically impaired.

Signs and symptoms

A short test for triathletes to find out if they suffer from low blood iron levels. When the body struggles to normalize hemoglobin levels in iron deficiency, lactic acid begins to accumulate in oxygen-deprived muscles. As lactic acid builds up, the athlete becomes more lethargic, prone to premature fatigue during exercise, may experience muscle burning, difficulty breathing, and decreased motivation to exercise. Chronic fatigue is the most common symptom, but other symptoms include an increase in the rate of perception of training load intensity (this rating can be expressed using the RPE, “rate of perceived exertion” numerical scales), nausea, tinnitus, flickering » before the eyes, frequent infections, respiratory problems, inability to think clearly, pale and haggard appearance. All of these symptoms should not be ignored. Constant training requires you to be healthy, fit and mentally strong, so don't let iron deficiency bring you down.

What causes low iron?

Although insufficient dietary iron intake is the most common cause of iron deficiency anemia, there are a number of other factors that affect iron stores in more than just athletes:

malnutrition: vegetarian, vegan, low protein diets,
heavy menstrual bleeding
illness, gastrointestinal tract or injury,
strenuous endurance training, which can increase iron loss through sweat
gastrointestinal bleeding, reduce iron absorption,
frequent use of aspirin or non-steroidal anti-inflammatory drugs,
training at high altitudes.

Iron monitoring

Chronic iron deficiency is an indicator that the body is under extreme stress. Long runs, extremely intense workouts, an unbalanced/unhealthy diet, a life of constant stress, insufficient sleep, lack of recovery time can all contribute to repeated iron depletion. Very often, runners find that they have low or low ferritin levels but normal hemoglobin values. Iron deficiency without anemia (i.e., low ferritin) has also been shown to affect endurance and performance. If you notice signs of iron deficiency, or iron deficiency anemia, see your doctor immediately. Periodically, it is necessary to monitor the state of the blood, hemoglobin, hematocrit, serum ferritin, serum iron, transferrin saturation, the total ability to bind iron, reticulocytes. Be aware that serum ferritin levels (a marker of iron levels in the body) can be falsely elevated up to 72 hours after a long, strenuous workout or marathon, or if the body is fighting infection or experiencing inflammation.

Sports anemia - a decrease in the number of red blood cells or hemoglobin in the blood

Endurance training increases blood volume, which dilutes the hemoglobin and hematocrit in the blood, making it artificially low when iron levels are actually within normal limits. Sports anemia is common when an athlete returns to training after a period of inactivity or when there is a sudden increase in training intensity. After the body gets used to the training load, hemoglobin and hematocrit will return to normal levels.

Increase your iron intake

Animal products such as red meat, dark poultry and seafood contain the most beneficial (absorbable) forms of iron (heme). While plant foods provide the body with non-heme iron, this form is more difficult to absorb. However, consuming foods rich in vitamin C in the same food can increase the absorption of iron from a non-heme source. For example, if you're eating a spinach salad, add strawberries or tangerine pieces to it for a boost in vitamin C. Consider combining heme and non-heme sources of iron, such as beans with dark turkey or beef. Include a small amount of red meat in your diet with pasta, soups, salads, and sandwiches.

In addition, it is important to understand that coffee, the acids in tea, and calcium-rich foods inhibit the absorption of heme iron. Bran or high-fiber grains (containing phytates and oxalates) may also inhibit the absorption of non-heme iron.

Men/women ages 9-13: 8 mg/day

Men aged 14-18: 11 mg/day

Women aged 14-18: 15 mg/day

Men aged 18-50: 8 mg/day

Women aged 18-50: 18 mg/day

Additional sources of iron

If you are found to be severely deficient in iron and are prescribed ferrous sulfate and ferrous gluconate supplements as a source of iron, review the dosage and intake guidelines before increasing your iron regimen as iron supplements can cause side effects such as constipation, diarrhea, and nausea. and dark chair. Make sure you follow the recommendations exactly as taking too much iron supplements can have adverse health effects.

A few guidelines when using iron:

remember to supplement vitamin C with food,
avoid iron intake with milk, coffee, tea, high fiber foods and antibiotics,
drink enough liquid daily,
iron supplements should be taken at the same time of day each day for best results.

Everyone knows that anemia is a disease that is associated with low levels of hemoglobin and red blood cells in the blood. Someone does not even know that he has such a disease. Many people know that it is necessary to replenish lost hemoglobin with products, but not everyone is aware of what is allowed and prohibited for anemia. Let's find out if it is possible to do exercise therapy with anemia, whether the disease and sports are compatible. How will the body behave when combining anemia with alcohol or smoking.

For the prevention of heart disease, blood, cardiovascular disease and anemia, physical exercise is effective and very useful. The main property of exercises for anemia should be properly selected exercises, which should be performed as directed by the attending physician. Physiotherapy exercises for anemia helps to improve the general condition of the patient, the main thing in this matter is to remember the constancy of their implementation.

Physical activity for anemia must be practiced daily, at the same time, so that the body develops a habit in this way. Some patients need rehabilitation for anemia or after it has been treated.

A number of exercises should be performed:

1 Lie on your back. Hands should be extended behind the head, legs should be closed together. Stretch, while strongly straining your knees, arms and feet. After that, you need to relax. Repeat the exercise 3 times.

2 The next exercise is performed lying on your back, bend your arms at the elbows, clench your fingers into a fist. While inhaling, raise your arms up, and while exhaling, lower your arms. You need to repeat the exercise 7 times.

3 Exercise is done in a sitting position. Sit down, put your hands on your knees. The arms are bent at the elbows, we strain each one in turn and lift it up. After we relax and lower our hand. It happens that when performing this exercise, a person wants to yawn. If you also want to yawn, feel free to do so. The thing is that the lungs began to work better, and the blood began to be saturated with oxygen. This exercise must be performed 4 times.

4 For the next exercise while sitting, make circular movements with the shoulder joint. 7 rotations forward and the same number of times back at an average pace. Keep your back straight during this exercise.

Anemia and the army

Some young people are worried about the question of whether they take in the army with anemia. Let's try to find an answer to it.

A low level of hemoglobin is considered a pathology; doctors of the military enlistment office treat it ambiguously. Someone receives a summons to the army and buckwheat increases the amount of iron in the blood, while someone after the examination is released from service.

If the stage of the disease is at a severe level, then there are symptoms:

sleepy;
fatigue;
noise in ears;
dizzy;
loss of consciousness.

Eligibility for military service can be determined based on the stage of disease severity. If there is evidence, confirmed by doctors, that the lack of iron in the body has led to serious consequences, then the young man cannot be drafted into the army. If the stage of anemia is mild, then most likely he will have to repay his debt to the Motherland.

Anemia and obesity

Anemia is the cause of obesity. Anemia and obesity have a lot more in common than you think. With anemia, the content of red blood cells and iron decreases, the blood is no longer able to perform its functions and is not able to transfer oxygen through the cells, taking in carbon dioxide. As a result, hypoxia begins, that is, starvation of tissues and organs.

In this regard, there is a feeling of apathy, do not want to work, there is a poor tolerance of physical exercises. Aversion to sports appears, but the need for sweets increases, and this is what leads to extra pounds.

According to the prevailing opinion, people involved in sports are distinguished by enviable health. However, intense physical activity has a downside - iron deficiency anemia becomes a common disease for them.

In runners, during training, the organs of the gastrointestinal tract are traumatized, blood is released through microcracks in the walls of the intestine. The body also loses iron through sweat. Due to the fact that training is carried out daily and takes a long time, iron deficiency anemia gradually develops. About half of female runners also suffer from this disease. Ignoring the insignificant, in their opinion, symptoms, they significantly aggravate the disease due to the monthly loss of blood during menstruation.

To some extent, proper nutrition can compensate for the lack and loss of iron in the body, but for a cardinal solution to the issue, a person should receive 8 mg of iron daily. And if we are talking about an athlete, then even more iron is needed, if only because they spend more than seven and more than a thousand calories per day, have profuse sweating, accelerated blood flow and red blood cell consumption, as well as a faster iron turnover. In cases of weight control and a strict diet, including fasting days, without taking iron-containing drugs, fainting, dizziness, weakness, and shortness of breath may occur. Adolescent athletes from youth teams, especially girls, should also take iron supplements.

Those athletes who train in high altitude conditions are required to take iron supplements.

Practitioners of sports teams know that when the first symptoms appear in the form of shortness of breath, delayed understanding of speech, fatigue, urgent measures must be taken - to prescribe iron-containing drugs. If this is not done, the body may respond with a failure of all systems - the athlete is threatened with loss of health.

Undoubtedly, at present there are about four dozen medical products, which are based on organic and inorganic iron salts. The low digestibility of the microelement in them is compensated by huge, many times higher than normal, doses that reach hundreds of mg. But such amounts of iron act on the intestines by passive diffusion and irritate them. Too high a dose of a microelement causes a burning sensation in the epigastrium, dizziness and pain in the head. In addition, getting used to increased doses, the intestines lose the ability to extract iron from food. And it turns out a vicious circle: taking medications destroys health, but without these pills, an athlete cannot function. How to be?

The food supplement from CJSC "T-HELPER BIOTECH" fully compensates for iron deficiency in the human body. The most important advantage of these tablets is that the trace element is contained in it in the form of natural hemoglobin, which is obtained from the blood of pigs and cattle. It is absorbed by 100%, an overdose is impossible, because in its structure it is identical to the protein that is eaten through meat of any variety.

Hey! In order to live, we need to breathe. And not only the lungs must be saturated with oxygen. Our entire body needs it. The role of the transporter of this life-giving element in our body is performed by a complex protein - hemoglobin. It ensures the normal functioning of every cell of our body (including our muscles).

It is also important for a bodybuilder to maintain its normal level, as the athlete's body is subjected to physical stress. Oxygen starvation for us is tantamount to a serious loss of strength and recovery abilities. What this means in practice - I think it's not worth explaining.

The lack of hemoglobin is not only a problem for athletes. Absolutely all people with its low concentration quickly get tired, irritated, feel weak in the limbs. Low hemoglobin causes and consequences of this disease will be discussed below in the article. First, let's get acquainted with the concept of "anemia".

ANEMIA - this is one of the symptoms of a pathological condition (disorders in the body). This phenomenon is accompanied by a decrease in the level of hemoglobin in the blood and the total number of red blood cells.

Some of the most common causes of anemia are:
disturbances in the formation or maturation of red blood cells,
acceleration of the process of destruction of red blood cells,
major blood loss
sometimes appears due to chronic diseases and tumors.

When there is too much or not enough iron in the blood, the body can malfunction. A small amount of iron leads to insufficient maturation of red blood cells. They become paler and smaller.
But sometimes the level of iron in the blood is too high. This happens when damaged red blood cells burst and iron enters the body. Gradually, iron penetrates into all organs of the body, causing their poisoning.
The poisoning of the heart is especially dangerous. In such situations, almost 100% of cases develop chronic heart failure which can lead to death.

So, the cause of such a disease as anemia or anemia is the lack of fully functioning red cells - erythrocytes in the human body.

Let us briefly recall the indicators of the level of normal hemoglobin in the blood:

In a child, the concentration of iron-containing protein varies depending on age: from birth to a month, indicators from 100 to 180 g / l are considered the norm; up to a year - 105 - 150 g / l; up to 12 years from 105 to 150 g / l.
In women 18-65 years old - 120-155 g / l. During menstruation, the level can drop to 100 g / l, and in pregnant women, the norm shifts from 110 to 140 g / l.
In men 18-65 years old - 130-160 g / l.

Types of disease

The causes of low hemoglobin can be different, and depending on them, the following types of anemia are distinguished:

Anemia due to lack of iron in the body. According to expert statistics, children and women with menstrual irregularities and during pregnancy are most susceptible to this disease. Also, the cause of such anemia is blood loss. Bodybuilders should especially pay attention to the fact that the disease may appear due to excessive physical exertion.
Vitamin deficiency - pernicious anemia. In this case, the body replenishes the level of hemoglobin through injections of vitamin B12. Infrequent cases in children due to lack of vitamin C and pyridoxine, which are important for the formation of red blood cells.
Aplastic anemia. Diagnosed when a person's bone marrow reduces the ability to produce new blood cells. The causes can be oncological diseases: leccosis, lymphoma, tumor.
hemolytic anemia. It occurs quite rarely. In this case, there is an increased destruction of red blood cells in the body due to a violation of hemoglobin or when internal hormones change.
Low hemoglobin in the blood. It can also cause sickle cell anemia, a hereditary disease. In the disease, red blood cells are sickle-shaped. As a result, blood flow may slow down.

To replenish iron in the body, doctors prescribe special diets, biologically active food supplements and various medications.

How does anemia manifest?

We will look at the clear signs of low hemoglobin in the most common case of iron deficiency disease. Symptoms of such anemia can be different:

Weakness;
Nausea;
shortness of breath;
Dizziness;
Heart palpitations;
The limbs are cold;
Temperatures up to 37.5°C appear;
Pain in the joints;
Tinnitus;
Sometimes the sense of smell and taste are distorted.

Outwardly, anemia is manifested in hair loss, pale skin, dry lips. In women, it can be observed in itching of the external genital organs. Very low hemoglobin can cause persistent headache, distraction, and even fainting. With a lack of iron, muscle relaxation occurs, which leads to urinary incontinence.

Hemoglobin below normal also leads to malfunctions of the immune system. Thus, even after a mild cold, serious complications can occur.

Why is a low protein indicator dangerous for pregnant women? Expectant mothers often develop uterine hypotension, hypoxia, the fetus may be delayed in development. And already in a born baby, low weight, disorders of the nervous system, underdevelopment, and future developmental deviations, both mental and physical, are observed.

The disease can be conditionally divided into 3 degrees:

Mild form with a hemoglobin index of 90 to 105 g/l;
Medium - from 75 to 95 g / l;
Severe - less than 70 g / l.
The critical form of 40 g/l requires immediate hospitalization.

However, low protein does not always indicate a disease. Doctor of Medical Sciences, hemostasiologist and specialist at the International Hospital for Hemostasis Baimuradova Seda notes that a slight decrease in the concentration of hemoglobin in the blood may be the result of the patient's postoperative condition, trauma, donation and malnutrition (for example, the problem of anemia is most often observed among vegetarians and people who sit on different diets).

Why are normal hemoglobin and iron levels so important for a bodybuilder?

The impact of physical activity

Iron connects proteins so that hemoglobin can be produced. Also, the trace element is directly involved in the formation MYOGLOBIN, a protein that oxygenates the muscles. Athletes and athletes during training and strength exercises are constantly tearing and restoring muscle tissue that has been damaged.

It has been proven that such sports that involve an intense load on the legs - aerobics, running - affect the decrease in the level of iron in the body.
Reduced levels of protein and iron in athletes are also called "sports anemia" and are explained by the increased destruction of red blood cells during exercise. The name "soldier's disease" is also known, since the destruction of red blood cells is associated with a load on the feet. The first sign of the disease is the dark red color of the athlete's urine.

Candidate of Medical Sciences, resuscitator Evgeny Subotov notes that well-cushioned sneakers will help to partially protect yourself from the appearance of sports anemia.

Pregnant women who exercise more than three hours a week, young mothers or those who consume less than 2,000 calories per day are at risk.

Performance

Hemoglobin affects the performance of athletes. It always maintains the constancy of the internal environment of the body, absorbs metabolic products that are released during intense muscle work, and also maintains the patency of blood vessels, while releasing a substance that expands them (nitric oxide), which is very important during intensive strength training.

Muscle activity may decrease from iron deficiency. Physical stress and all kinds of muscle damage from injuries received by bodybuilders reduce the concentration of the trace element. In addition, inadequate nutrition also leads to anemia.

Susan Kleiner, MD, and recognized nutritionist in Winning Sports Nutrition notes that female athletes who followed certain diets needed extra iron (18 mg) daily.

Also, an international nutritionist writes that iron deficiency can be without anemia. In this case, a person has a normal level of hemoglobin, but the amount of ferritin, a special form of iron, decreases.

Cornell University research is excellent at showing how iron affects the body. The subjects were untrained, deficient women who took the supplement during strength training. The experiment showed that they became more enduring and the level of oxygen in the body increased, which also affects the rapid recovery after training and performance.

Back in 1949, it was proved that the hemoglobin level of athletes is 37% higher than that of untrained people. However, this figure rises slowly over several years of intense exercise. For example, 9 months of training increases protein by 6%.

Kleiner Susan, however, reminds in the book that if hemoglobin levels are normal, additional iron supplements will not improve performance in the gym. When there is still a need for dietary supplements, a nutritionist advises taking 8 mg for men and 18 mg for women.

But she also warns not to overdo it and not add higher doses of the trace element to your diet. Too much iron can lead to HEMOCHROMATOSIS. Then the microelement accumulates in the organs and leads to disruption of the liver.

Methods for increasing hemoglobin

The blog also features natural and medical methods to increase Hb levels. There you will learn more about what hemoglobin is with a simple and interesting example!

The expert draws attention to the fact that in products of plant origin, the trace element is absorbed worse than iron in meat. Therefore, she advises including liver, lean meat, oysters in your weekly diet.

For those who refuse iron-rich meat, due to the increased amount of fat in it, Susan Kleiner recommends consuming at least a small amount of beef and animal fat. And for those who do not eat meat at all, the nutritionist writes the following advice:

Replace meat with fruits and vegetables that are high in iron. This includes: leafy vegetables (cabbage, broccoli, arugula, spinach, lettuce, sorrel), dried fruits (dried apricots, raisins), cereal dishes and bread.
Achieve the best absorption of the trace element by also consuming foods rich in vitamin C.
Do not mix foods that are high in fiber and nutrition with high concentrations of iron in one meal. Since fiber inhibits the absorption of beneficial trace elements. Do not take antacids (medicines used to treat acidic disorders of the gastrointestinal tract) and do not drink tea in combination with iron-rich foods.

Since the daily need for a trace element depends on gender and age, below you can read how much you need.

Babies up to a year - 67 mg;
Children 1-13 years old - 22 mg;
Girls - 15 mg;
Boys - 11 mg;
Adult women - 18 mg;
Adult men - 8 mg;
Pregnant - 80 mg.

And to help, a list of some iron-containing foods (per 100g):

Pork liver - 19 mg;
Beef - 3.1 mg;
Chicken - 2.1 mg;
Lamb - 2 mg;
Egg yolk - 7.2 mg;
White dried mushrooms - 35 mg;
Seaweed - 16 mg;
Brewer's yeast - 18 mg;
Cocoa - 12.5 mg;
Lentils - 12 mg;
Buckwheat - 8 mg;
Beans - 5.6 mg;
Apples - 2.2 mg.

Features of iron replenishment, and what drugs can help?

Dietitians also draw attention to an important feature that should not be forgotten: no matter how much iron is contained in foods, the intestines can only absorb up to 2 mg. An adult man loses 1 mg per day, women with a normal menstrual rhythm - 1.5 mg.

If you have laboratory confirmed low hemoglobin, what then to do? The cause should be eliminated (bleeding, chronic inflammation cured). Further, doctors already attribute drugs for oral administration in capsules, drops, tablets, with the help of which the level of protein in the blood should normalize. After that, another 4 months of treatment-and-prophylactic dose are prescribed.

There are several features of treatment that everyone needs to know:

On the shelves in pharmacies, in most cases, you can find medicines that contain trivalent iron, but it is difficult to digest and often causes constipation and unpleasant sensations of heaviness in the stomach. The body absorbs better BIVALENT iron.
Dairy products inhibit the absorption of trace elements in the body. Therefore, it is better to exclude them from the diet for the duration of treatment. Or use at least 5 hours after the drug.
Reduced acidity of the stomach also stops the absorption of iron.

Medicines for anemia

The most popular medicines for anemia are:

Aktifferin (ferrous iron) - a feature of the drug can be called the fact that the course of treatment weakens the symptoms of anemia, and serine increases the body's ability to absorb iron.
Hemoheller (ferrous iron) is considered a dietary supplement and is based on specially prepared animal blood hemoglobin. It is safe for health, has no side effects, is used to prevent microelement deficiency and to treat anemia.
Ferlatum (ferric iron) is prescribed for the risk of anemia in expectant mothers, during adolescence during intensive growth, with prolonged bleeding and with an unbalanced diet.

ATTENTION! It is strongly not recommended to take medication without a doctor's prescription, as an overdose can lead to poisoning.

Hemoglobin and sports scandals

Unfortunately, in the big world of sports, doping scandals are indispensable. Every Olympic Games, dozens of athletes are eliminated from the competition. However, there are medicines that are considered doping helpers, but they are also excellent drugs for treatment, so doping is sometimes useful.

There are some interesting facts about hemoglobin doping sports scandals.

It is known that a large number of red blood cells improves the athletic performance of athletes due to increased endurance. The concentration of red blood cells increases during oxygen starvation, for example, if you train high in the mountains. However, it is not always convenient to conduct classes in mountainous areas, and it is very expensive.

But in conditions of such a hunger strike, the body produces a special hormone in the kidneys called erythropoietin. It accelerates erythropoiesis, that is, the process of the appearance of new red blood cells, thus performing a hematopoietic function.

In order to replenish red blood cells, already in the 50s, experiments began with the transfusion of athletes with their own blood. A month before the competition, blood was taken from the athlete, frozen, and poured back the day before the start. Thus, the level of erythrocytes became artificially increased, and the athlete felt more alert, stronger and more enduring.

In 1984, at the Olympics, this method of transfusion was considered doping and the committee excluded several cyclists from the competition. And when scientists first artificially synthesized the hormone erythropoietin, the need for transfusions disappeared by itself. It began to be used very widely, and, for example, in 1998, at the most prestigious cycling race, the Tour de France, there was a resonant scandal, which was accompanied by searches, arrests of athletes and coaches.

However, official testing for erythropoietin did not begin until the 2000 Sydney Olympics with two tests, urine and blood. In addition, restrictions were also introduced on the level of hemoglobin in the blood of Olympians.

Therefore, many associate erythropoietin with doping scandals, while this hormone helps in medicine: it is used in the treatment of anemia in patients with AIDS, cancer, and chronic renal failure.

Recently, doctors from Germany discovered new qualities of the hormone. Haller Hermann, Head of the Department of Nephrology at the Hannover Medical School, says:

“This hormone is excellent for patients with cardiovascular diseases. Erythropoietin also has a positive effect on the restoration of damaged tissues and an increase in the number of stem cells. Animal experiments have shown that the hormone stops the development of kidney failure, and in myocardial infarction reduces the number of tissues affected by the disease.

The article turned out to be quite large, because I consider this topic very important for our health. Write in the comments if you have encountered the problem of low hemoglobin and how did you deal with it?

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Anemia- a decrease in the concentration of hemoglobin (Hb) in the blood below 130 g / l in men and 120 g / l in women. According to WHO data for 2008, the prevalence of iron deficiency anemia (IDA) in the world's population is 24.8%. IDA occurs in all age groups but is most commonly seen in infants, preschool children, pregnant women, and women of childbearing age. The main reasons for the development of iron deficiency are chronic blood loss, nutritional deficiency, impaired absorption of iron and its increased consumption in certain periods of a person's life. In recent publications, the role of Helicobacter pylori in the development of IDA is increasingly discussed.

There are several stages in the development of iron deficiency: depletion of iron stores in the bone marrow and liver, a decrease in the activity of erythropoiesis and the development of IDA. Iron deficiency, regardless of the presence of anemia, negatively affects the cognitive functions of the brain, in particular, cognitive abilities; increases susceptibility to infections due to a negative effect on the immune system; reduces efficiency and physical endurance; causes trophic changes in the skin, its appendages, mucous membranes.

Athletes, especially endurance athletes, have lower Hb and hematocrit values due to an increase in plasma volume of 10-20%, this is the so-called dilution anemia. In contrast, 20 weeks of strength training raises hematocrit. The decrease in Hb during endurance training is called pseudoanemia. An increase in plasma volume is a mechanism for adapting the body to regular hemoconcentration during training. In ultramarathoners (56 km), hematological evidence of breeding anemia disappears on the 6th day after the marathon.

In addition, iron deficiency is thought to be a cause of athlete overwork syndrome. The results of a detailed clinical and laboratory examination of 50 athletes in this condition are described, including, in addition to hematological examination, biochemical analysis of blood serum (urea, creatinine, electrolytes, uric acid, glucose, liver enzymes, albumin, globulin), determination of thyroid hormones and immunological analysis. for Epstein-Barr virus and cytomegalovirus. Pathology during the interpretation of the analyzes was detected only in 2 athletes and included a serum ferritin concentration between 15 and 20 µg/l and transferrin saturation<15%.

Iron is used by the body for oxygen transport and energy production, and therefore greatly influences athletic performance. Iron losses can occur due to hemolysis during intense exercise, hematuria, increased sweating, and gastrointestinal bleeding. Parallels are drawn between anemia in chronic inflammatory diseases and "sports" anemia. The acute phase response is a common response to both exercise and disease. Elevated levels of cytokines (particularly interlein-6) in this response increase hepatic production of the hepcidin peptide. Hepcidin has pronounced antibacterial properties due to the ability to destroy the bacterial membrane, it is called the "iron-regulating hormone", which links the immune system and iron metabolism. The main role of hepcidin is protection against the toxic effects of excess iron. Hepcidin is involved in the regulation of the following processes: iron absorption in the small intestine, release and recycling of iron ions in the macrophage system, and transport of iron across the placental barrier. Accordingly, excessive production of hepcidin leads to disruption of the above processes, which can explain iron deficiency in athletes. The question of new therapeutic possibilities for influencing this mechanism of iron deficiency during sports remains open.

Research suggests that the cause of this "sports" anemia was an intensive regimen of physical training.

How common is anemia and iron deficiency among highly skilled athletes? Hematological parameters were studied in 303 men and 273 women of the sporting elite in Australia over a period of three years. Serum ferritin less than 30 ng/ml (people need exogenous iron supplementation) was found in 10 men and 52 women. Iron deficiency was not clinically manifested. Standard laboratory parameters (hemoglobin, hematocrit, iron concentration) were normal or minimally altered. Apparently, in elite athletes it makes sense to control hemoglobin and additionally serum ferritin. Isolated deviations that are close to normal and not accompanied by painful manifestations can almost certainly be ignored.

A study of the prevalence of anemia among 28 female football players of the Swedish national team showed the presence of iron deficiency in 57% and iron deficiency anemia in 29%.

There is evidence that exogenous iron supplementation (the recommended dose is 2 x 100 mg of elemental iron per day) in cases of iron deficiency in patients without anemic syndrome can improve athletic performance. The use of iron by athletes without iron deficiency does not lead to positive consequences.

In a double-blind study, 41 untrained iron-deficient women without IDA received iron supplements (FeSO4) or placebo for six weeks. The results were evaluated by performing a 15 km training session on a bicycle ergometer. A significant effect of treatment with iron preparations was manifested in an increase in maximum oxygen consumption. Thus, iron deficiency without IDA interferes with aerobic endurance and needs to be corrected.

IDA often develops in vegetarians and those on restrictive diets. It should be clarified that the largest amount of heme iron is found in meat products. Heme iron is actively captured and absorbed by the intestinal mucosa in unchanged form. The processes of absorption of heme iron in the intestine do not depend on the acidity of the medium and inhibitory food factors. It has been established that from animal products, iron is also absorbed much more intensively from heme than from non-heme ferroproteins (ferritin, hemosiderin). So, despite the fact that the total iron content in the liver is high, the absorption of iron from it is lower, since iron is found in the liver mainly in the form of hemosiderin and ferritin, and in meat products - in the form of heme. The content of iron in the liver is three times higher than in chicken meat, but its absorption, on the contrary, is almost two times lower. In other words, a person will receive an equal iron content if he eats 100 g of liver or 150 g of chicken.

When choosing a diet as one of the components of the prevention and treatment of IDA, one should take into account not so much the content of iron in a particular food product as the degree of its absorption, depending on the form in which iron is present. Iron absorption occurs predominantly in the jejunum. The absorption of non-heme iron from cereals, fruits and vegetables is significantly reduced in the presence of oxalates, phytates, phosphates, tannins and other inhibitors of ferroabsorption. The absorption coefficient of iron from beef meat (heme iron) is 17-22%, and for non-heme iron from fruits, vegetables - no more than 2-3%. That is why the recommendations that are often given to patients with iron deficiency anemia - to eat large quantities of fruit juices, apples, pomegranates, buckwheat and other foods in order to compensate for iron deficiency cannot be considered justified.. A complete and balanced diet according to the main ingredients only allows you to “cover” the physiological need for iron, but not eliminate its deficiency.

It is impossible to compensate for iron deficiency only by diet therapy without medicinal iron-containing preparations.. When prescribing any iron preparations, it is necessary to calculate the individual need for it for each patient, based on the fact that the optimal daily dose of elemental iron is 4–6 mg/kg. The average daily dose of iron in the treatment of IDA is 5 mg/kg. The use of higher doses does not make sense, since the amount of absorption of iron does not increase.

An important factor in the success of therapy is the sufficient duration of a saturating course of iron therapy (usually about three months) followed by maintenance courses. In this case, the regulated dose for daily intake is 200 mg of ferrous iron. This figure is calculated on the basis of those ideas that only 10-15% of the iron entering the body is absorbed (even in the form of special tablets).

Improving the delivery of oxygen to tissues by increasing the amount of red blood cells seemed to be one of the tempting ways to increase athletic performance. Initially, in order to improve hematological parameters, athletes conducted training in conditions of high-altitude hypoxia (more than 2000 m above sea level). Transfusions of own erythrocyte mass or blood of donors were used as doping. In the case of a transfusion of homologous blood, doping can be determined by quantifying blood group antigens. In the years that followed, there was an explosion regarding the use of erythropoietin. As a result of commercial companies offering erythropoietin as a means of enhancing sports performance, the number of thrombosis and cardiovascular accidents in athletes has increased due to an increase in red blood cells. Methods have been developed for determining pellagized erythropoietin in the blood of athletes, which speeds up and simplifies the process of doping control and makes the risk of using erythropoietin unjustified.