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Int J Child Health Hum Dev 2014;7(1):11-19 ISSN: 1939-5965

Nova Science Publishers, Inc.

Iron deficiency and iron deficiency anemia in adolescent


athletes: A systematic review

Aditya Dewoolkar, MD, Neil D Patel, BA, Abstract


and Colleen Dodich, MD
Department of Pediatric and Adolescent Medicine, Anemia has been identified as the most common medical
Western Michigan University School of Medicine, condition among athletes. It is more common in females.
We conducted a literature search for articles describing
Kalamazoo, Michigan, and Michigan State University
anemia in adolescent athletes and analyzed the data with
College of Human Medicine, East Lansing, Michigan, respect to prevalence, diagnostic criteria, effect of iron
United States of America supplementation, and prevention. Among the studies, the
prevalence of anemia ranged from 22-65% using
hemoglobin as the most common screening test. Although
all studies showed greater incidence of iron deficiency and
iron deficiency anemia in athletes compared to the control
population, there was no consensus about the role of iron
supplementation.

Keywords: Adolescence, anemia, athletes, public health

Introduction
Most athletes are in excellent health with lifestyles
combining regular exercise with a nutritious diet
(1,2). However even the healthiest athletes are at risk
for iron deficiency and iron deficiency anemia.
Athletes subjecting themselves to prolonged strenuous
exercise, and daily endurance training risk developing
anemia. Iron deficiency can occur with or without the
development of anemia and may be symptomatic or
asymptomatic (3). The laboratory parameters of the
same are seen in table 1.
Anemia is present when red cell mass is reduced
below normal limits. Measuring red cell mass directly
is uncommon. Instead, the hemoglobin level and
hematocrit are commonly used (see table 1). The
clinical presentation and management of anemia
varies according to the mechanism of red cell mass
loss. The mechanism of anemia can be classified

Correspondence: Colleen Dodich, MD, Department of using three broad categories: hypoproliferation,
Pediatric and Adolescent Medicine, Western Michigan ineffective erythropoiesis, and blood loss or
University School of Medicine, 1000 Oakland Drive,
Kalamazoo, Michigan 49008, United States. E-mail:
hemolysis.
Colleen.dodich@med.wmich.edu