When it comes to physical performance, many female athletes find themselves caught between balancing dietary preferences and ensuring that iron intake is adequate. This is particularly the case for plant-based athletes or with limited intake of red meat.

Intense physical exertion increases the body’s need for iron, and repeated sessions that deplete the body may lead to iron deficiency anaemia with inadequate iron intake or poor absorption. As previously mentioned, iron deficiency may contribute to exhaustion and will likely have an adverse effect on training and competing.

Iron is an essential mineral that plays a vital role in metabolism and the transportation of oxygen through your body. Up to 65% of the body’s iron is found in haemoglobin. Haemoglobin is the substance found in red blood cells that delivers oxygen from your lungs to your body tissues via your bloodstream. This means that low haemoglobin levels lead to decreased oxygen delivery to the body’s tissues, working muscles and organs.

Iron is also essential for the formation of myoglobin in muscle cells, a protein that carries and stores oxygen in muscle tissue. As oxygen is needed for aerobic metabolism, it’s easy to understand how low myoglobin (oxygen transportation around the muscles) impairs your aerobic function and ultimately, physical performance. It is also essential for brain health, physical growth and the syntheses of several hormones in your body. If you aren’t sure of the common signs of iron deficiency, you may like to read our previous blog here.

Put simply, if you are suffering from anaemia or are iron deficient your muscles will receive less oxygen and produce more lactic acid during training sessions, and your health and wellbeing will be severely compromised and could lead to serious health issues.

Energy production takes place in the mitochondria as part of the electron transport chain. In this process, a charged gradient is created across the membrane, which in turn drives the synthesis of energy as adenosine triphosphate (ATP).  Both haem animal and plant based forms of iron are important for the protein complexes within the electron transport chain.

The mitochondria is one the most iron-rich organelles in the body, with the skeletal muscle containing 10–15% of the body’s iron that is particularly concentrated in type-1 slow twitch muscle fibres. These fibres have high mitochondrial content, slow contraction rates and a reliance on aerobic metabolism and oxidative phosphorylation.

Endurance athletes typically have more slow twitch muscle fibres than Type-2 fibres.

Vegetarian or plant-based athletes are at a much higher risk of iron deficiency and may need significantly more iron in their diet, or supplementation, due to the reduced bioavailability of iron from plant-based foods and often of knowledge around sources of iron rich foods. Pairing plant-based foods with a source of vitamin C can increase absorption.

It is important to remember that your iron deficiency may have nothing to do with your iron intake and their could be other physiological and environmental circumstances that are playing a part.

We are passionate about providing balanced and well-researched information to athletes. Hundreds of athletes have used our handy anaemia quiz to help determine their likelihood of having anaemia or low iron levels. If you’re unsure, take our Anaemia Quiz here.


Want to know more? Contact the Athlete Sanctuary and learn how we can assess your risk of iron deficiency and anaemia, and work with you to increase health, wellbeing and performance.


Alaunyte I, Stojceska V, Plunkett A. Iron and the female athlete: a review of dietary treatment methods for improving iron status and exercise performance. J Int Soc Sports Nutr. 2015;12. doi:10.1186/s12970-015-0099-2

Halas M. Part 4: Special Considerations for Vegans and Vegetarians. The Plant-Based Boost Nutrition Solutions for Athletes and Exercise Enthusiasts. Middletown, DE: Super Kids Nutrition Incorporated, 2019.

Semenova, E. A., Miyamoto-Mikami, E., Akimov, E. B., Al-Khelaifi, F., Murakami, H., Zempo, H., … & Ahmetov, I. I. (2020). The association of HFE gene H63D polymorphism with endurance athlete status and aerobic capacity: novel findings and a meta-analysis. European Journal of Applied Physiology, 120(3), 665-673.

Stugiewicz, M., Tkaczyszyn, M., Kasztura, M., Banasiak, W., Ponikowski, P., & Jankowska, E. A. (2016). The influence of iron deficiency on the functioning of skeletal muscles: experimental evidence and clinical implications. European journal of heart failure18(7), 762-773.


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