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Endurance Athletes Have an Increased Risk for Iron Deficiency

Poor performances and feelings of fatigue may signal a need to get your levels checked.

It’s common to associate a poor performance with low iron. “I had a bad race, maybe I should check my iron?” “I’m feeling fatigued during workouts—could it be my iron levels?” I get these questions from the athletes I work with a lot.

And while there are countless variables that can contribute to poor performances or fatigue, one thing we do know is that iron is important for runners. If your iron levels are low and you don’t do anything about it, you will eventually feel the negative impact on performance. Here’s what you need to know about both iron and ferritin levels.

What is iron and why is it important for athletes?

Iron is an essential mineral found in red blood cells that is important for oxygen transport in the blood and to muscles, energy production, cognition, and immunity. The reason many of us worry about our levels is that iron is lost in many ways: in the urine, through the menstrual cycle, blood loss in the gastrointestinal (GI) tract, sweat loss, and the breakdown of red blood cells via the impact of our foot strikes. Plus, chronic use of nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen)—ones often used by athletes—and antacids can also lead to iron deficiency. 
​

Iron levels are especially important for female athletes: According to a paper in the European Journal of Applied Physiology, the prevalence of iron deficiency is around 15 to 35 percent in female athletes and 3 to 11 percent in males. Females, endurance runners, vegans, vegetarians, and athletes with low energy availability are at an increased risk for iron deficiency.


What are some key symptoms of low iron?

The classic signs of iron deficiency, with or without anemia, include lethargy, fatigue, negative mood state, and difficulty concentrating. However, runners may notice symptoms that mimic overtraining, reduced work capacity during training, impaired responses to training, and ultimately poor performance. The only way to determine if low iron is the culprit is to have a blood test.

What about anemia?

Anemia is a condition in which the blood doesn’t have enough healthy red blood cells. Although iron deficiency anemia is the most common type of anemia, it is one of many different types. It is possible to have iron deficiency prior to developing a diagnosis of iron deficiency anemia. Over time, iron deficiency will lead to anemia if no action is taken because the body will exhaust its iron stores, known as ferritin.

So what’s the deal with ferritin levels?

Ferritin, as mentioned above, is an important blood marker that indicates iron storage. There is a wide range for what is considered to be a “normal ferritin level,” ranging from 12 to 300 nanograms per milliliter (ng/mL).

“However, linking ferritin levels (e.g. levels greater than 35ng/ml) directly to performance is very challenging, as there are so many things that impact performance,” Trent Stellingwerff, PhD, Senior Advisor for the Canadian Sport Institute Pacific tells Runner’s World.

In fact, high iron levels can be very toxic for the liver and heart. “We aim for ferritin greater than 35ng/ml and clinically normal hemoglobin, but appreciate individual athlete norms as well,” says Stellingwerff.

Thus, a current routine assessment of iron deficiency should include the following blood markers: ferritin, hemoglobin, and transferrin saturation. Iron deficiency occurs in three stages using the following ferritin levels proposed in a recent paper in athletes:

Stage1 - Iron deficiency/depletion: ferritin less than 35 ng/mL, hemoglobin and transferrin levels will still be normal. There is little evidence to suggest you will notice any fatigue at this point, but it’s important to correct and prevent iron deficiency anemia.

Stage 2 - Iron deficient non-anemia: ferritin less than 20ng/mL, low transferrin, and normal hemoglobin. You may start to feel some of the symptoms above and performance may be negatively impacted.

Stage 3 - Iron deficiency anemia: ferritin less than 12 ng/mL, low transferrin and hemoglobin. You will notice key symptoms above including impaired endurance performance.

How often should I have my iron levels checked?

As suggested in a recent 2019 article published in a European Journal of Applied Physiology, high-risk runners should be screened regularly and considerations for the frequency of iron blood screening are based on the athlete’s past history. Although not comprehensive, some guidelines are listed below:

Annually: runners with no history of iron deficiency, no fatigue after an extended rest period

Biannually: previous history or low ferritin (iron depletion stage 1), female, intention to increase training volume or training at altitude within the next 12 months

Quarterly: any recent history of iron depletion/deficiency, vegetarian/vegan, individuals with any evidence of low energy availability, high training volume, and fatigue/lethargy, plans to train at altitude within the next 6 months.

Ferritin, an acute phase reactant protein, can be falsely elevated with inflammation after intense exercise. Thus, it’s important to avoid any muscle-damaging or intense exercise about two to three days prior to your routine blood test. Other suggestions for standardization include testing first thing in the morning and in a well-hydrated state.

Work with your doctor to determine the best course of action and figure out if supplementation is right for you.

Should runners traveling to altitude be concerned about levels?

Training at low to moderate altitudes provides an environmental stimulus to increase red blood cells with the goal of improving performance at sea level. With this increase in red blood cell production, comes an additional need for iron. A review paper by Stellingwerff et al. (2019) suggests checking iron status prior to altitude training to ensure that levels are in the optimal range prior to leaving.

“However, if a runner is just going to altitude for a race or short period of time, the impact of iron is much less,” Stellingwerff says. “Although, all endurance athletes should aim to have ferritin levels well into the healthy and normal range.”

How can runners optimize iron absorption?

You can have a solid iron-rich fueling plan, but is your nutrient-timing and combination of foods on point? Iron absorption may be impaired post-exercise due to increased levels of hepcidin, a hormone released by the liver that regulates the ability to absorb or recycle iron (e.g. increased hepcidin levels will inhibit iron absorption).

Inflammation is believed to be a strong up regulator of hepcidin. According to an article published in Sports Medicine in 2020, hepcidin increases around three to six hours post-exercise and increases towards the end of the day.

Thus, the optimal timing for iron absorption is within 30 minutes after a morning workout when hepcidin levels are low. Runners can optimize iron absorption use the following strategies:
​

Avoid dairy, coffee, and tea (which decrease absorption of iron) for an hour before or after a meal.

Cook with a cast-iron skillet or a product like a Lucky Iron Fish, which may be a cost-effective strategy for increasing the iron in conjunction with other methods according to one study.

Consume “heme iron” rich foods such as beef, eggs, tuna, lamb, and kangaroo (if available)

Improve absorption of “non-heme iron” sources (almonds, figs, apricots, kidney beans, green leafy vegetables, tofu, dark chocolate) by pairing with heme-rich sources and/or ~50 milligrams (mg) of vitamin C (1/2 cup of pineapple, strawberries, broccoli, or red peppers).

If taking an iron supplement (prescribed by a physician), take with vitamin C-rich food. Emerging evidence suggests alternate day dosing to be just as effective as daily for raising ferritin levels and better tolerated for runners with a sensitive gut.


Finally, not every bad race indicates your iron is low, but it is a good idea to get checked prior to taking any iron supplements. There is no evidence that higher ferritin levels are better (e.g. aiming for 300), and supplementation is not likely to improve performance in non-depleted runners. Iron supplementation should only occur under physician supervision.

You can have a solid iron-rich fueling plan, but is your nutrient-timing and combination of foods on point? Iron absorption may be impaired post-exercise due to increased levels of hepcidin, a hormone released by the liver that regulates the ability to absorb or recycle iron (e.g. increased hepcidin levels will inhibit iron absorption).

Inflammation is believed to be a strong up regulator of hepcidin. According to an article published in Sports Medicine in 2020, hepcidin increases around three to six hours post-exercise and increases towards the end of the day.

Thus, the optimal timing for iron absorption is within 30 minutes after a morning workout when hepcidin levels are low. Runners can optimize iron absorption use the following strategies:
​

Avoid dairy, coffee, and tea (which decrease absorption of iron) for an hour before or after a meal.

Cook with a cast-iron skillet or a product like a Lucky Iron Fish, which may be a cost-effective strategy for increasing the iron in conjunction with other methods according to one study.

Consume “heme iron” rich foods such as beef, eggs, tuna, lamb, and kangaroo (if available)

Improve absorption of “non-heme iron” sources (almonds, figs, apricots, kidney beans, green leafy vegetables, tofu, dark chocolate) by pairing with heme-rich sources and/or ~50 milligrams (mg) of vitamin C (1/2 cup of pineapple, strawberries, broccoli, or red peppers).

If taking an iron supplement (prescribed by a physician), take with vitamin C-rich food. Emerging evidence suggests alternate day dosing to be just as effective as daily for raising ferritin levels and better tolerated for runners with a sensitive gut.


Finally, not every bad race indicates your iron is low, but it is a good idea to get checked prior to taking any iron supplements. There is no evidence that higher ferritin levels are better (e.g. aiming for 300), and supplementation is not likely to improve performance in non-depleted runners. Iron supplementation should only occur under physician supervision.

(05/02/2021) Views: 3,159 ⚡AMP
by Runner’s World
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Fotyen Tesfay Hailu From Track Star to Marathon Sensation

Ethiopia’s Fotyen Tesfay Hailu has rapidly emerged as one of the most exciting athletes in women’s distance running, combining world-class speed on the track with a marathon debut that instantly placed her among the greatest performers in history.

The 28-year-old Ethiopian captured global attention on March 15, 2026, at the Zurich Barcelona Marathon, where she ran 2:10:51 in her first attempt at the classic distance. The performance moved her to No. 2 on the all-time women’s marathon list and confirmed what many insiders had suspected for years — Tesfay possessed the perfect combination of speed, strength, and efficiency to become a major marathon star.

Before stepping up to the marathon, Tesfay had already established herself as one of the world’s elite distance runners. She owns personal bests of 14:28.53 for 5,000 meters, 29:47.71 for 10,000 meters, and an impressive 1:03:21 for the half marathon. Those performances placed her among the very best female distance runners in the world long before she made her marathon debut.

Tesfay first gained major international attention through her aggressive style on both the roads and track. Unlike some runners who rely heavily on tactical racing, she has consistently shown she is comfortable pushing the pace from the front. That fearless approach translated beautifully to the marathon in Barcelona. Rather than fading late, as many athletes do in a debut, she looked smooth and controlled deep into the race while maintaining one of the fastest paces ever recorded by a woman.

Her marathon breakthrough did not happen overnight. Ethiopia’s deep tradition in distance running has produced countless champions, but Tesfay’s development has stood out because of her versatility. She has demonstrated elite ability on the track, cross country, and roads, proving she can adapt to almost any racing situation.

Observers were particularly impressed by how relaxed she appeared while running at a pace few women in history have ever sustained for 26.2 miles. That has led many in the sport to believe her future performances could be even faster as she gains more experience at the marathon distance.

Tesfay’s emergence also comes during a remarkable era for women’s marathon running. Times once considered impossible are now becoming reality, and Tesfay appears positioned to play a major role in pushing the event to even higher levels.

With her combination of track speed, endurance, and calm racing style, Fotyen Tesfay Hailu now looks capable of becoming one of the defining marathon runners of her generation.

(05/18/2026) Views: 62 ⚡AMP
by Boris Baron for My Best Runs
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Dennis Kipkogei Announced Himself to the World with Record-Breaking Mainz Half Marathon Triumph

Kenya’s next great road-running sensation may have officially arrived.

At just 24 years old, Dennis Kipkogei delivered a breathtaking performance at the Gutenberg Mainz Half Marathon on Sunday May 10th 2026, storming to victory in a sensational course-record time of 59:14. In doing so, the emerging Kenyan star not only shattered the previous mark but also elevated the status of the German event onto the global stage of elite half marathon racing.

His remarkable run now ranks Mainz among the fastest half marathons in Germany, with only Berlin producing quicker winning times in recent years. But beyond the statistics, it was the authority, composure, and dominance of Kipkogei’s performance that captured attention.

The Kenyan crossed the finish line more than a minute ahead of the chasing pack, underlining the gulf in class between himself and the rest of the field. Fellow Kenyans Kelvin Kipruto and Jamal Kiprono completed a clean sweep of the podium, clocking 60:25 and 60:29 respectively, but the day unquestionably belonged to Kipkogei.

What makes the performance even more impressive is how rapidly the young runner is adapting to the international stage. Mainz marked only Kipkogei’s second race outside Kenya following his breakthrough appearance at the Berlin Half Marathon in March, where he finished runner-up after spending much of the race assisting with pacing duties. That performance hinted at enormous potential. His display in Mainz confirmed it.

This time there were no questions, no supporting role, and no shared spotlight. Kipkogei took command of the race with maturity far beyond his years, producing a fearless front-running display that signaled the arrival of a serious contender in global distance running.

His 59:14 performance now places him among the fastest half marathon runners in the world this season and strengthens Kenya’s already rich legacy in long-distance road racing. More importantly, it suggests that Dennis Kipkogei possesses the rare combination of speed, endurance, and tactical intelligence required to become one of the sport’s future headline names.

For German road racing, it was a historic morning. For Dennis Kipkogei, it may prove to be the moment the world truly took notice.

(05/18/2026) Views: 46 ⚡AMP
by Erick Cheruiyot for My Best Runs.
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Shericka Jackson Sends a Powerful Warning Shot with Brilliant Shanghai Triumph

Under the dazzling lights of Shanghai, Shericka Jackson reminded the athletics world exactly why she remains one of the most feared women in sprinting. In a fiercely competitive women’s 200 metres packed with elite talent, the Jamaican superstar stormed to victory in a commanding 22.07 seconds, delivering one of the strongest statements of the early season.

With a legal +0.3 wind behind the field, Jackson looked sharp, composed, and devastatingly efficient through every phase of the race. From the moment she attacked the curve, her trademark blend of power and relaxation separated her from the field, before she surged away in the final metres to secure an emphatic win. More than just another Diamond League success, the performance served as a clear reminder that Jackson is already building serious momentum ahead of the championship season.

The race carried additional intrigue with the long-awaited return of Shaunae Miller-Uibo to the Diamond League circuit. Competing in her first appearance at this level in three years, the Bahamian star produced an impressive run of 22.26 seconds to finish second, showing encouraging signs as she continues her comeback journey. Her presence added extra quality to an already stacked contest and elevated the atmosphere inside the stadium.

Yet the night ultimately belonged to Jackson. The double world champion did not simply win — she controlled the race with the authority of an athlete fully aware of her dominance. At this stage of the season, such a performance carries enormous significance. While many athletes are still searching for rhythm and race sharpness, Jackson already appears locked in, confident, and dangerously close to peak form.

What makes the victory even more compelling is the manner in which it was achieved. There was no visible strain, no desperate lean at the finish, only the calm assurance of a sprinter operating several levels above the field. It was the kind of performance that sends a message across the global sprinting landscape: Shericka Jackson is not easing into the season — she is attacking it.

As the road toward the major championships continues, Shanghai may well be remembered as the night Jackson officially announced her intentions to the world. If this performance is an indication of what is to come, the women’s sprint scene could be heading toward another season dominated by Jamaican brilliance.

(05/18/2026) Views: 46 ⚡AMP
by Erick Cheruiyot for My Best Runs.
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Gift Leotlela Delivers the Ultimate Birthday Statement with Shanghai Sprint Triumph

Just four days after celebrating his 28th birthday, South African sprint star Gift Leotlela handed himself the perfect present — a sensational victory in the men’s 100 metres at the Shanghai Diamond League.

Leotlela stormed to victory in a blistering 9.97 seconds, edging one of the strongest sprint fields of the season in a race that was decided by the narrowest of margins. Kenya’s Ferdinand Omanyala crossed the line in 9.98, matching the time of American sprint sensation Kenny Bednarek, who settled for third after a dramatic finish.

The race delivered elite-level drama from start to finish, with American star Trayvon Bromell and Australia’s Lachie Kennedy both clocking 10.01 to finish fourth and fifth respectively in one of the fastest and most competitive 100m contests of the year.

For Leotlela, however, the night belonged entirely to him.

The South African has quietly been building momentum throughout the season, and Shanghai now feels like confirmation that he is ready to challenge the very best consistently on the global stage. His latest triumph comes after opening his 2026 campaign with victory at the South African Championships last month, a performance that hinted at what was to come.

Now, with a sub-10 second victory against a stacked international field, Leotlela appears to be picking up exactly where he left off after his impressive fifth-place finish at last year’s World Championships.

What made the performance even more remarkable was the composure he displayed under immense pressure. Against proven championship medal contenders and some of the quickest starters in the world, Leotlela stayed relaxed, executed brilliantly through the drive phase, and unleashed a powerful finish to snatch the win in the closing metres.

The result further strengthens South Africa’s growing reputation as a sprinting powerhouse and signals that Leotlela could be a major force as the season progresses toward the world’s biggest championships.

In Shanghai, the timing could not have been more poetic. Four days after turning 28, Gift Leotlela did not just celebrate a birthday — he announced himself as one of the most dangerous sprinters in the world.

(05/18/2026) Views: 52 ⚡AMP
by Erick Cheruiyot for My Best Runs.
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Ayantu Kumela and Kelvin Kiptoo Kororia Rule Riga in Spectacular Marathon Triumphs

The 2026 Rimi Riga Marathon produced a thrilling showcase of endurance, dominance, and elite distance running as Ethiopia’s Ayantu Kumela and Kenya’s Kelvin Kiptoo Kororia emerged victorious with commanding performances in the Latvian capital.

Kumela successfully defended her women’s crown in breathtaking fashion, delivering an even stronger display than last year to cement her growing legacy in Riga. The Ethiopian star crossed the finish line in an impressive 2:26:40, nearly two minutes faster than her previous winning performance, underlining both her consistency and remarkable progression on the marathon stage.

Running with confidence and control from the opening kilometers, Kumela gradually distanced herself from the chasing pack before powering home to a memorable back-to-back triumph. Her composed race execution and devastating late surge once again proved too strong for the elite field assembled in Riga.

Fellow Ethiopian Obse Abdeta Deme secured second place in 2:27:50, while Sadura Adawork Aberta completed an all-Ethiopian podium after clocking 2:29:05 for third.

In the men’s race, Kelvin Kiptoo Kororia produced a stunning performance of his own, delivering a masterclass that left no doubt about his superiority on the day. The Kenyan runner stormed to victory in 2:08:58, finishing with authority after an electrifying run through the streets of Riga.

Kororia looked in complete command throughout the race, maintaining a relentless rhythm before unleashing a powerful finishing stretch that thrilled spectators at the finish line. His victory was not only decisive but also symbolic of a runner operating at the peak of confidence and strength.

Ethiopia’s Getachew Kene Tufa claimed second place in 2:11:29, while Kenya’s Stephen Kipkemoi Kibor completed the podium in third after clocking 2:12:27.

With both races delivering fast times and unforgettable moments, the 2026 Rimi Riga Marathon once again lived up to its growing reputation as one of Europe’s premier road racing events. Yet above all, the spotlight belonged to Kumela and Kororia — two champions whose dominant performances transformed Riga into a stage of marathon excellence.

(05/17/2026) Views: 125 ⚡AMP
by Erick Cheruiyot for My Best Runs.
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Lattelecom Riga Marathon

Lattelecom Riga Marathon

If you have never been to Riga then, running a marathon or half-marathon could be a good reason to visit one of the most beautiful cities on the Baltic Sea coast. Marathon running has a long history in Riga City and after 27 years it has grown to welcome 33,000 runners from 70 countries offering five race courses and...

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