My Athlete Story

Believe it or not… low ferritin is very common amongst endurance female athletes and a smaller percentage of male athletes. I hope my story is seen by a parent of an athlete, maybe a coach or by the athlete. If we can help athletes BE THE BEST they can be by providing education and awareness of low ferritin and its effect on the endurance athlete then LET’S DO IT! I wish I had somebody to help me sooner but then I wouldn’t be who I am today through my struggle.

(Click picture to see my journey)

The signs of low ferritin are fatigue, feeling foggy and tiredness. During runs, the runner could experience legs feeling heavy or having trouble breathing during distance races or training runs. 

The most important step you can take is eating a very balanced diet with plenty of fruits, veggies, protein and complex carbohydrates. Understand that food is fuel and that you NEED healthy carbs to fuel for your goals. Include foods that have iron such as animal products (heme iron  – most easily absorbed) or plant sources such as spinach, raisins, beets (non-heme iron). Eating a balanced diet can help improve your energy levels in all the micronutrients your body needs to thrive.

Steps You can Take:

  • Go get a physical and talk to your doctor to learn if you are deficient in any categories of your bloodwork. According to, normal ferritin levels range from 12 to 300 nanograms per milliliter of blood (ng/mL) for males and 12 to 150 ng/mL for females. If your ferritin level is 12ng, that would be considered in range for a healthy adult however, as an endurance athlete your body requires more transportation of oxygen through the body. 
    *Not a doctor, this is based on experience, research and advice from medical friends.
  • Meet with a dietician or nutritionist! Like a coach, it is important for an athlete to have accountability and to learn about what you need to meet your specific needs based on your energy output. 
  • Take a nutrition class! The more you learn, the more you will implement to fuel your goals and to live a healthy life! 

    Nutrition is a HUGE component in your success in reaching your BIG GOALS! Food is FUEL! Food gives you energy to perform, to recover and to rebuild! It CAN be simple but it takes some work to learn what is best for you! Set yourself up for success! 🙂

Importance of Ferritin for the Endurance Female Athlete

Runner Optimal Levels

“An adequate supply of iron must be available to enable red blood cells to transport oxygen to your hardworking muscles. Mild anemia can impact athletic performance since it causes a general feeling of tiredness.”

“Once ferritin levels drop below 50 ng/mL, you’ll start to notice signs such as dizziness, headaches, irritability and trouble breathing.”

Female athletes are more likely to experience an iron deficiency during their running career due to menstrual cycles and footstrike hemolysis. The more miles we run, the more our iron levels can vary. 

Examining your diet is the first step to combating anemia.

Food Sources with Iron

Heme Iron (animal sources)

Red Meats: Beef, Eggs, Poultry

*Very important to improve Iron Bind Capacity (TIBC)

Non Heme Iron

Kale, Spinach, Lentils, Beets, Raisins, Dark chocolate, Dates, Apricot, Beans

Pair Iron Food Sources with Vitamin C to enhance absorption especially important with Non Heme iron sources.

Tomatoes, Bell Peppers, Oranges, kiwi, strawberries, sweet potatoes

When consuming iron sources, be aware that caffeine and calcium can inhibit absorption. Give yourself at least a 2-3 hour window.

Supplementation should be discussed with a medical professional that understands runners optimal ferritin levels, iron saturation and TIBC.

As mentioned above, ferritin levels of 50ng is sufficient for endurance runners. However, levels are individualized based on what helps you feel your best with optimal levels for your body and training volume.

Blood Work Panel can be ordered through your doctor or through a lab such as LabCorp On Demand or Ulta Lab (cheaper option).

Cookbooks that support a Well Balanced Diet for a Runner:

Run Fast, Eat Slow by Shalane Flanagan and Elyse Kopecky

Runner’s Kitchen by Emma Coburn


Low Ferritin and Iron Deficiency Anemia in Distance Runners — A Scientific Guide for Athletes and Coaches — HIGH PERFORMANCE WEST

Iron and the female athlete: a review of dietary treatment methods for improving iron status and exercise performance – PMC (

How Low Ferritin Levels Affect Women Runners – Outside Online

Footstrike is the major cause of hemolysis during running | Journal of Applied Physiology

Low Iron Saturation Treatment: Causes Of Low Iron Levels In Blood (

TIBC (Total Iron-Binding Capacity) Test: What It Is & Results (

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