Iron deficiency without anaemia: importance of early screening and approaches to correction

Iron deficiency is a common and clinically significant issue among athletes, as it can negatively affect the functioning of various body systems, including the nervous, cardiovascular, immune, and endocrine systems. Moreover, insufficient iron levels can impair an athlete’s ability to train effectively, reduce aerobic capacity, and compromise competitive performance. For this reason, the International Olympic Committee recommends regular iron status screening as part of routine health assessments for elite athletes. This study analyses male and female athletes' haematological parameters and iron metabolism indicators. While most red blood cell indices and serum iron levels fall within the reference range, a downward trend in MCH values was observed in female athletes. The most sensitive and specific marker of iron deficiency—serum ferritin—revealed significant sex-related differences. The average ferritin level in male athletes (45,5 ± 10,4 μg·l-1) met the optimal threshold, suggesting sufficient iron stores. In contrast, female athletes had a mean ferritin level of 28,0 ± 9,8 μg·l-1 (60% exhibited prelatent iron deficiency and 10% had latent iron deficiency). These findings highlight the hidden nature of iron deficiency in female athletes and the need for early screening and intervention. The paper also discusses evidence-based recommendations for treating iron deficiency anaemia, emphasising the importance of correct administration, avoiding interactions with inhibitors of iron absorption, and ensuring appropriate therapeutic doses.