Iron Status in Ultraendurance Triathletes

In brief: Using several hematologic indexes, researchers examined the iron status of 50 ultraendurance athletes participating in the 1988 Ironman Triathlon in Hawaii. Fifteen (30%) of the 50 triathletes had at least one suboptimal iron index: Two exhibited stage 2 iron deficiency in the presence of normal hemoglobin levels; eight had normal ferritin levels but subnormal levels of transferrin saturation and iron; three had abnormal levels of total iron-binding capacity; and two had low hemoglobin levels with all other iron indices normal, which indicated dilutional anemia. These data suggest that several indexes need to be examined when assessing the iron status of triathletes and that unusual values do not necessarily reflect actual iron deficiency.