The Only Supplement I Take: Iron

I’ve never been one of those crazy runners who always looks for the next best fad in diet and nutrition; I’m so out of place walking into a supplement store and I’ll never understand the differences between B12, B6, B1… but the one thing I will take religiously for the rest of my running career is iron.

NOTE: Obviously I’m not at all qualified to talk technicalities about iron or supplements; this is all from my own research, what I’ve been told by doctors, and my experience as an elite athlete.

WHAT is iron? Iron is a mineral that’s friends with hemoglobin. Hemoglobin is a protein that allows red blood cells to carry oxygen to the muscles. The more hemoglobin you have, the more oxygen your blood carries and the stronger you feel. Iron helps hemoglobin do its job to the best of its ability!

In a nutshell, runners need iron to keep running. When you’re iron deficient or anemic, your energy levels are down, your muscles are weak, you can’t make it through the day or your training without feeling sluggish, out of shape, or exhausted, and you’re at risk for larger health problems down the line. (Note: anemia is a decrease in hemoglobin, meaning your blood cannot carry enough oxygen to restore your muscles.) Iron deficiency and even anemia can be super hard to notice– most of the time, we’re training so hard that we’re always a big sluggish or tired! But when it truly begins to affect your workouts (like you can’t make it through a workout you used to dominate or even easy runs feel extra hard), it’s time to get your iron checked.

To determine your iron levels, you get your blood ferritin level checked– and be sure to get the actual number of your ferritin count, because “normal” levels and runner levels are a little different (and different for guys and girls). Runners, in general, are safe if their ferritin count is over 40– in the 30s is usually a little low and under 30 is a major warning sign (again, this is just from my experience– definitely talk to your doctor, coach, and trainer about what they think is safe for you). If you’re in the teens or below, you’re putting yourself at major risk for anemia and time off of running. Trainers like to see elite runners with ferritin levels at 80 or above.

When you get your ferritin number, it’s time to start your iron supplementation– because even if you have a “healthy” ferritin level, supplementing with consistent iron will help ward off any drop in levels that could happen due to a change in training, weather, sickness, or just life (women definitely need to keep an eye on iron, as we lose blood every month… just saying…).

The two best options for supplementation are pills or liquid. Pills can work for those just starting their journey with iron, although I found they really upset my stomach for the first few weeks I took them; liquid is usually more concentrated, so you can get more out of less, but it takes a little more work than just popping a pill in your mouth. Iron should be taken on as empty a stomach as possible, to aid in absorption, and it’s best combined with Vitamin C (toss that pill back with OJ or dilute your liquid iron in a glass); it should NOT be taken with Calcium, as Calcium blocks iron absorption; caffeine doesn’t really jive with iron either, so space out your supplement and Calcium/ Caffeine intake as much as possible!

I started taking iron in college, when my ferritin level was a little too low for my trainer’s taste. I took a pill and really didn’t like it… so after a month or so, I stopped. I didn’t have my ferritin level checked until I was an elite and was a 13– not good. My coach at the time started me on liquid iron and I took 3 teaspoons a day for a month; later, a nutritionist told me to keep up with it, at least 1 teaspoon a day, but I eventually stopped. When I joined Furman Elite, we had our levels checked before our first altitude trip in 2013; I spent the month in Flagstaff taking 2 teaspoons a day and kept taking a spoonful on and off for the next year. In 2015, I really dialed in and began taking a spoonful every night and when I was tested before our spring altitude trip, I was at a 93– a great indicator of the fitness that followed!

Why can’t you supplement with iron through diet alone? It’s easy to get iron through meat, spinach, lentils… but when you’re training at a high level, it’s nearly impossible to consume enough food with iron that will actually absorb into your blood.

If you choose to take liquid iron, I would recommend taking it at the end of the day (give yourself some time between your dessert and falling into bed to empty your stomach as much as possible) with orange juice (liquid iron supposedly stains the teeth, which is why you dilute it in another liquid). Some people will wake up early to take it before their morning coffee, but I’m not that disciplined!

Before you dive into iron supplementation, get your ferritin level checked. Have a doctor advise you on how much to supplement with! But once you begin, keep it consistent– it’s easy for levels to ebb and flow and having a regular supplement to fall back upon will really help your overall fitness and energy!

For more info about iron supplementation and iron deficiency and running, head here, here, here, and here!