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Iron and the female athlete: A review of dietary treatment methods for improving iron status and exercise performance.
This article is a review of the literature assessing the incidence of iron deficiency in physically active women. It also covers the effects and the best methods of treatment for deficiency. The paper concludes that it is still unclear as to whether or not iron deficiency has negative effects on athletic performance but, increased dietary intake of iron can aid in the regulation of iron status. It is important to note that there is still information that is unknown about the effects or deficiency and the importance of supplementation.

The prevalence and impact of heavy menstrual bleeding among athletes and mass start runners of the 2015 london marathon
A survey was conducted online and in person before the 2015 London Marathon Exhibition asking female athletes about heavy menstrual bleeding, training, iron supplementation, and anemia. From these data were compiled to look for existing correlations. A strength of this study was the sample size as over 1000 women participated. However, the study could have many confounding factors as over half of the sample was self-selected because it was online and the in person group were all marathon runners who's training program is not necessarily indicative of that of all female athletes. It was found that heavy menstrual bleeding, anemia, and iron supplementation were all correlated with negative effects on athletic performance implying that supplementation may not be effective.

Anaemia and Iron Deficiency in Athletes.
This article addresses the current methods for treatment and management of iron deficiency and anaemia in athletes. It defines deficiency and anaemia, discusses potential risk factors and consequences, and provides information on prevention and treatment of these conditions. This paper is useful because it covers topics such as iron turn over and menstruation. It also provides a good general overview of iron deficiency and all of its components.

Iron Supplementation Improves Energetic Efficiency in Iron-Depleted Female Rowers
This study was conducted on 31 collegiate female rowers with normal Fe or with non-anemic iron deficiency. These athletes were randomly assigned to the placebo group or the supplement group. A strength of this study is that they controlled for food intake and found no significant differences. They also recorded supplementation compliance. However, this study is not necessarily applicable to the general athlete population as only one gender of one sport and a very small age range were used as the sample population. The athletes with iron deficiency showed higher ferritin levels and greater energetic efficiency during workouts. This indicates that for athletes who are iron deficient, oral supplementation can have a positive impact on athletic performance.

Combined Heme Iron Supplementation and Nutritional Counseling Improves Sports Anemia in Female Athletes.
This study looked at the effects of oral iron supplementation on 30 female collegiate athletes. Measurements were thorough including BMI measurements and blood testing. However, subjects were composed of only women who complained about experiencing symptoms of anemia therefore, making the results not even applicable to all anemic women athletes. The study found that supplementation was an effective against their anemia but recommends regulating conditioning and dietary intake as well, especially for long term management.

Iron status and the female athlete.
This article discusses the effects of iron deficiency and iron deficiency anemia on the body and focuses on how these effects impact physically active women. This article takes a more biochemical approach and as opposed to covering general symptoms delves into the causes for complications that accompany this lack of iron. This is important for explaining why iron deficiency is more prevalent in athletes as opposed to the general population. The author also touches on potential treatment methods including supplementation and dietary changes.

Iron Supplementation Benefits Physical Performance in Women of Reproductive Age: A Systematic Review and Meta-Analysis.
This article covers the effects of oral iron supplementation on women in numerous studies. The paper uses a regimented protocol for determining if a paper is qualified or not. However, only three of the studies found could be considered to have little bias. It was found that oral supplementation improved maximal and submaximal performance.

The Unexplored Crossroads of the Female Athlete Triad and Iron Deficiency: A Narrative Review.
This review focuses more on the interaction of iron deficiency with female athlete triad which describes bone loss, reproductive function, and energy deficiency. In essence it highlights the fact that iron deficiency and female athlete triad are very interconnected as one tends to exacerbate the other. This provides reasons as to why athletes, especially female athletes are more effected by iron deficiencies. The connections made in the article also make the effects of deficiency more obvious to the reader such as eating disorders and reproductive issues.

Efficacy of iron supplementation may be misinterpreted using conventional measures of iron status in iron-depleted, nonanemic women undergoing aerobic exercise training.
In this study untrained women were used to determine the effects of oral supplementation in iron depleted women who performed mild aerobic exercise. The study consisted of almost 400 participants making the data a good representation of physically active women. However, all of these women were between the ages of 18 and 26 which limits the age group to which these findings could apply and the period of time during which the study was performed was short. The study indicated that supplements improved the iron statuses of these women but, physical training reduced the effectiveness of supplementation.

Why do women use dietary supplements? The use of the theory of planned behaviour to explore beliefs about their use
In this study a questionnaire was sent to 400 of the 15,000 random women in the UKWCS database. The questionnaire found that the women who took supplements were more likely to believe that what they were doing had some health benefit, by either combating a preexisting condition or preventing an ailment from developing. The researchers attributed this effect for those that use iron supplements to the well-known concept that iron supplementation can prevent anemia. The study received good data from a multitude of subjects. However, the data found cannot be assumed to be the perspectives of the general public as self-selection should be factored in as not all of those who received a questionnaire returned one and all of the subjects were women. This article supports the concept that iron supplementation is important to the health of individuals.

Dietary Supplements and Sports Performance: Minerals
This article is a review of the literature that focuses on the effects of mineral supplementation on athletic performance. The author is reputable and draws on information from many sources. However, the reader must trust that the sources this author references are good sources. This article upholds the concept that iron supplementation in athletes can be very beneficial yet, it warns about the possible side effects of over supplementation.

Is iron treatment beneficial in, iron-deficient but non-anaemic (IDNA) endurance athletes? A systematic review and meta-analysis
This review article compared the data from various studies on IDNA athletes to determine if iron supplementation had any benefit on them. The researchers found 26 studies out of 5,715 that met their criteria. However, in their criteria they did not mention that they checked to ensure the reputability of these studies. This review confirms that iron supplementation can have a beneficial effect on those who are only iron deficient.

Progressive Increases in Dietary Iron Are Associated with the Emergence of Pathologic Disturbances of Copper Homeostasis in Growing Rats.
This study demonstrates one of the possible side effects of iron supplementation. The study split rats into groups with varying iron content in their food. The experiment contained a good method including a control group and multiple test groups. Yet, mice were used as the test subjects, therefore relating the study to humans can be a stretch given large differences in anatomy. The experiment indicated that copper depletion can be a side effect of over supplementation, indicating that people who are taking large doses of iron or supplementing when their iron levels are normal or high could be at risk of developing copper deficiency.

Iron Deficiency and Anemia among Collegiate Athletes: A Retrospective Chart Review
This study, performed at the University of Wisconsin, involved testing the iron statuses of athletes throughout their collegiate career. They found that over 30% of female participants in the study were iron deficient while only 3% of male participants had the same deficiency. This study tested almost 3000 individuals making the sample size one of its strengths. Yet, the study only tested college aged athletes so it cannot be generalized to the public or even athletes in general. Also, there was no control group of sedentary individuals to which to compare their results and the study could only draw correlation not causation. Lastly, this study best supports that female athletes are significantly more prone to iron deficiency and the authors suggest that iron supplementation would be an inexpensive fix to this issue.

The prevalence and impact of heavy menstrual bleeding among athletes and mass start runners of the 2015 London Marathon
A survey was conducted online and in person before the 2015 London Marathon Exhibition asking female athletes about heavy menstrual bleeding, training, iron supplementation, and anemia. From these data were compiled to look for existing correlations. A strength of this study was the sample size as over 1000 women participated. However, the study could have many confounding factors as over half of the sample was self-selected because it was online and the in person group were all marathon runners who's training program is not necessarily indicative of that of all female athletes. It was found that heavy menstrual bleeding, anemia, and iron supplementation were all correlated with negative effects on athletic performance implying that supplementation may not be effective.

Intravenous Iron Supplementation in Distance Runners with Low or Suboptimal Ferritin
In this study elite distance runners with low iron status or suboptimal iron levels were either given an oral iron supplement or IV supplement over a 6 week period. A strength of this study is that about equal numbers of women and men were tested making the findings applicable to athletes of both genders. The sample size of this study was only 27 people which is a possible weakness as it allows for a lot of variance making the findings difficult to apply to the general athletic population. Similarly, the oral supplementation athletes were told to take vitamin C with the iron supplement but, no regulation of this variable was noted. It was found that hemoglobin mass and V˙O2max were increased in individuals that were given the iron supplement intravenously. This supported the theory that iron supplementation can improve athletic performance in those that are iron deficient. However, the oral supplementation did not show this improvement.