Iron, Athletes & Ice Chips. What is the Connection?

iceberg at sunset 

The most globally deficient mineral worldwide is iron, due to the growing plant-based population. Research shows, iron deficient endurance athletes are increasing in numbers, with the reasons behind this trending surge a mystery.

Low Iron is often found in up to 35% of female athletes due to the menstrual cycle however, low iron is also increasing; up to 15% in male athletes.

The top 2 iron functions are; oxygen transport and energy metabolism. 

Muscles need oxygen

Outlying trends could be the fundamental connection, as can be the soil to table evolution and lack of nutrient density found in even the cleanest diets.

Plant-based diets, insufficient caloric intake (RED-s), and elevated physiological metabolic needs are most likely the culprit behind low iron levels. We certainly can’t rule out genetics and predisposed iron related diseases(anemia/ulcers) however, the basis of low iron levels in athletes is probably due to diet and metabolic demands.

iron deficnecy anemia

How do I know if I am low in iron?

The quick and efficient means to know where your iron levels are is to get a blood test.

To help diagnose iron-deficiency anemia, ordering a blood test through your doctor or via Inside Tracker online, to check your complete blood count (CBC), hemoglobin levels, blood iron levels, and ferritin levels.

Low iron affects hemoglobin and ferritin levels.

Hemoglobin is a red blood cell protein that carries oxygen to your body's organs and tissues, while transporting carbon dioxide from your organs and tissues back to your lungs.

The normal range for hemoglobin is:
                  Male: 13.8 to 17.2 grams per deciliter (g/dL) or 138 to 172 grams per liter (g/L)
Female: 12.1 to 15.1 g/dL or 121 to 151 g/L.
hemogblobin test chart
Ferritin is a blood protein that contains iron. Ferritin data helps you and your doctor understand how much iron your body stores.
The normal range for blood ferritin is: 
Men: 24 to 336 micrograms per liter.
Women: 11 to 307 micrograms per liter.

We condone biomarker testing however, where the diagnostic ‘disconnect’ may be is in the current biomarker ‘ranges’.

The existing CBC ranges your primary care physician reviews and bases our health on, is derived from metadata for a ‘conventional’ healthy society.

Endurance athletes are far from ‘conventional’.

The endurance athlete metabolic utilization and physical demands require a minimum of a 10-20% increase in micro and macronutrients to optimize the body organ and tissue functions. The takeaway is: although a blood serum test shows ‘in-range’, and you feel the symptoms that commonly exhibited with low iron levels, this is an area of opportunity to explore and fill in the gaps with a targeted iron diet and or iron supplementation.

Low iron levels present in a variety of ways however, the most common physiological symptoms are fatigue and a continuous feeling of being cold. This mineral deficiency oversight is extremely common in winter months since individuals find it difficult to discern whether the chill is a result of the winter environment, or a metabolism issue.

What may present as the potential of overtraining fatigue that doesn’t go away following a 20% training reduction for a few weeks, is a red flag to low iron levels.

Why the low iron uptick in athletes?

Diet Trends

Are you leaning into the plant-based trends? Plant-based athletes are growing in popularity dues to personal environmental beliefs and the ever-growing research behind reduced inflammation, gut health, recovery, and performance benefits. 

Whatever your rational and reasoning behind this diet shift is; or will be, this evolving trend requires a higher demand for physical micronutrient science data.

Humans evolved as a hunter gatherer carnivorous species, which provided a substantial micro and macronutrient diet. Non processed foods, rich in enzymes, non-synthetic vitamins and all macro and trace minerals.

The current diet issues for plant-based individuals are the consumption of fortified processed foods.

Processed foods fortify with nutrients that are: cheap, not very absorbable and interact with other components in a diet which makes (especially)minerals less absorbed.

Diets high in grains, breads muffins, crackers reduce mineral absorption. Not only iron, but ALL minerals.

Phytates and oxalates are the active components in grains that reduce the mineral absorbability.

Phytate or phytic acid stores phosphorus in many plant tissues, especially bran and seeds. Phytates and oxalates can form complexes with metals or proteins reducing their bioavailability in the gastrointestinal tract. Phytate is thus considered an anti-nutrient compound.

Oxalates are found in green leafy vegetables, tea, beans, nuts, beets which bind to iron, zinc, magnesium, and calcium and prevent them from being absorbed.

Click here for natural food sources of iron

woman in green dress holding shave ice bowl

Where do ice chips fit into the picture?

While on your winter runs, do you find yourself craving icicles hanging from a tree or roof top?

Is ice a ‘must have’ in your beverages?

Is the crunching of ice cubes or slushies a part of your diet?

Can’t go without summer popcicles?

The oddity behind low iron is, a fixation on eating ice chips and or a need for ice cold beverages. This relationship is not understood however, is apparent in many individuals that have low iron ranges.

Iron deficiency anemia signs and symptoms may include:

  • Extreme fatigue.
  • Irritability.
  • Weakness.
  • Pale skin.
  • Chest pain, fast heartbeat or shortness of breath.
  • Headache, dizziness or lightheadedness.
  • Cold hands and feet.
  • Inflammation or soreness of your tongue.
  • Brittle nails.
  • Eating Ice Chips.

Once thought that hemolysis (broken blood cells); as the result of runner’s feet striking pavement was the cause however, we also find low iron in cyclists.

Metabolic iron demands for athletes require a deeper scientific review, which we know our our scientific community is currently working on. Until those studies are completed and the results shared, what each athlete needs to pay attention too are the physical/ psychological signs and symptoms displayed.

How to fix low iron levels?

Diet Evaluation:

Log your dietary food and beverage intake> including alcohol.

Rule out underlying root causes:

  •             Ulcers
  •             High stress, acid reflux, dark stool.
  •             Copper* deficiency

*A common mineral deficiency associated with low iron levels.

Copper pots and pans hanging from wall

Using real metal; iron and copper, pots and pans helps reduce mineral deficiencies 

Supplement with a high absorbing Iron Chelate when Hepcidin is at its lowest levels.

Per the NIH chart below the male and female amount of iron needed daily is:

Table 1: Recommended Dietary Allowances (RDAs) for Iron [5]






Birth to 6 months

0.27 mg*

0.27 mg*

7–12 months

11 mg

11 mg

1–3 years

7 mg

7 mg

4–8 years

10 mg

10 mg

9–13 years

8 mg

8 mg

14–18 years

11 mg

15 mg

27 mg

10 mg

19–50 years

8 mg

18 mg

27 mg

9 mg

51+ years

8 mg

8 mg


When is the best time to take iron?

The latest research indicates that the best time to take iron supplements is 12 hours after your last bout of exercise, or in the morning before exercise.

Exercise releases Hepcidin, a 25-amino-acid (aa) peptide protein hormone, which is the central regulator of systemic iron homeostasis. Hepcidin excess is associated with inflammation anemia, chronic kidney disease and iron-refractory iron deficiency anemia.


Understand where your iron levels are during your monthly cycle.

Test iron biomarkers 2 weeks before the menstrual cycle and 1-2 days following.


Plant-based: Quarterly or every 6 months biomarker evaluation.

Non-Plant Based: Bi-annual biomarker testing

 What happens if you have too much iron in your diet?

The same thing that happens to the shovels you left out in the rain; they rust.

Cell oxidation(rust), liver toxicity, reduced zinc absorption & adverse biochemical reactions.

High-dose iron supplements; 65mg daily, can cause gastrointestinal effects, including gastric upset, constipation, nausea, abdominal pain, vomiting, and diarrhea.

Your liver is a primary organ for athletes and shouldn’t be compromised, or at the very best should be looked after for serious performance results. The liver is a vital organ and plays a central role in energy exchange, hepcidin production, protein synthesis as well as detoxification, the elimination of waste products from the body.

The liver stores glycogen, releases energy as glucose & oxidized fat, and converting metabolites into macronutrients, amino acids into proteins, and transforming potential energy into chemical energy potential energy. 

If not for the hepatic response, sustained exercise would be impossible.

Too much iron will compromise liver function and performance.

The key to iron is to keep it balanced for each individuals exercise output and personalized utilization.