Athletes And Iron Overload – A Population At Higher Risk?

Hemochromatosis is the most common deadly genetic disorder in the world.

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1 in 9 are affected. Having the mutations increases one’s risk of storing excess iron in tissues and organs. Iron overload is the  trigger for a dozen cancers, chronic and deadly illnesses including heart attacks, liver disease, liver and heart failure, arthritis, diabetes. It has one of the lowest diagnosis rates in the world with less than 8 percent discovering they have it in time to treat properly, or at all.

But are athletes at greater risk of iron overload than the general population?

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A number of studies have concluded YES, they are.

But Why?

1. Iron Supplements

Although numerous science based studies have determined it generally does not improve performance, iron is often used by elite athletes. This trend has been on the rise for decades, promoted by the vitamin industry.  Publicity about it’s use has influenced mid-range athletes and the larger population of citizen athletes training for charity runs, spartan races, marathons, teams of all sports and cycling clubs.

The physiologic changes induced by exercise can mimic iron deficiency and decrease hemoglobin and ferritin concentrations over the short term. Determination of serum transferrin concentrations identify true iron deficiency, but too many athletes simply take iron pills or multivitamins with large doses of iron without being tested for real deficiency, overload or genetic mutations… because they heard it was good for them and might give them an edge.

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Since HH has one of the lowest diagnosis rates in the world, with less that 8 percent discovering they have it in time to treat, or at all, a large segment of athletes are playing russian roulette every time they take iron pills.

In contrast, increased iron stores in the body are a frequent finding in elite athletes who have used long-term iron supplementation. For example,  elite runners have increased intestinal blood loss, but can be compensated by enhanced absorption of dietary iron i.e eating a healthy diet of food. Taking iron pills and supplements only increases the risk of iron overload (especially in athletes with undiagnosed hereditary hemochromatosis) without improving performance.

2. More than a casual relationship between elite athletes and a higher prevalence of hereditary hemochromatosis than general population has been established. 7978390

No less than four independent scientific studies in Britain, France, Spain and Australia have reached similar conclusions – athletes test for HH at higher rates than general population, not due to supplements, but at the genetic level.  The Madrid study findings indicate a high prevalence of HFE gene mutations in highly trained professional athletes populations (49.2%) compared with sedentary controls (33.5%). In a study of French athletes across several sports the primary conclusions were that while 27% of the French population is heterozygous (carriers) for mutations in this gene, 80% of the French athletes who won international competitions in rowing, Nordic skiing, running and judo displayed mutations in one or more allele of HFE, thus demonstrating the existence of a favorable phenotype linked to this heterozygosity. Additional conclusions from these studies included:

A. The frequency of HFE mutations in elite athletes is up to twice as high as in controls. (across all the studies)

B. In the international podium group from the Fench study, 80% of athletes had mutations in the HFE gene.

C. The HFE mutations are favorable to high level performance in athletes.

D. Heterozygous HFE mutations could be associated with a favorable phenotype.

3. Athletes get tested more frequently and thoroughly for their physical condition than do the general population.  del_65461_medium1

A strong argument, backed by data from three medical system surveys, indicates one reason more athletes know they have HH than do in the general population – and get treatment – is because they schedule more physicals, or are mandated to take them by sponsoring organizations, request more tests be run and are viewed by health professionals as stronger candidates for specific panels and tests outside of routine blood work. Because they present less factors such as drinking, smoking, poor diet, lack of activity, doctors look beyond presenting symptoms for a source.

The Take Away:

  1. While more studies need to be done regarding the correlation between elite performance and prevalence of gene mutations, athletes of all stripes should NOT take iron supplements and vitamins with iron in them.
  2. Highlights the need for widespread, routine iron panel testing for all populations to catch this disorder and it’s damaging effects early and often. Sign our petition to make those tests routine again  sign petition here

Two videos of world class athletes who discovered they have HH and were in iron overload:

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