Iron Deficiency and Aerobic Exercise Performance: A Systematic Review and Meta-analysis
Pasricha SR, et al.
High-confidence evidence from multiple solid studies
Summary
A meta-analysis examining the effect of iron deficiency (with and without anemia) on aerobic exercise performance. Iron supplementation was associated with recovery of hemoglobin levels and improvements in VO2max. Even iron deficiency without anemia reduced exercise tolerance, which improved with iron supplementation.
Key findings
- 1
Iron supplementation improved VO2max by an average of +3.9 ml/kg/min (95% CI: 1.9–5.9)
- 2
Even latent iron deficiency without anemia caused fatigue and reduced endurance, reversible with supplementation
- 3
Menstruating women, endurance athletes, and vegetarians are at particularly high risk
- 4
Excess supplementation (beyond normal hemoglobin levels) may increase oxidative stress; self-directed over-supplementation is not recommended
Last checked: 2026-06-24