Do endurance athletes need more iron?

Yes, many endurance athletes have higher iron needs than the general population. Research indicates that 15-35% of female athletes and 3-11% of male athletes are deficient in iron [1]. Exercise increases hepcidin, an iron regulating hormone made in the liver, resulting in reduced iron availability [1]. However, other factors such as menstrual blood losses, altitude training, and inadequate intake can also contribute to low iron status in endurance athletes [1]. 

Female athletes have even higher iron needs due to menstrual blood losses and are twice as likely as sedentary women to develop iron deficiency [1,2]. Iron status of all athletes should be closely monitored, and iron supplements may be needed to restore normal levels. Iron deficiency anemia can take 3-6 months to correct, depending on baseline levels.