Sports Anemia

Sports anemia is not representative of true pathology. Rather, it represents an adaptive response to strenuous training and is caused by an expanded plasma volume. The degree of anemia typically correlates with the intensity of training. Plasma volume can expand by 5% to 20%. This adaptive response begins a few days after starting or intensifying training. Moderate exercisers may see a decrease in hemoglobin (Hb) of 0.5 g/dL, and elite athletes may have an apparent Hb decrease of 1 g/dL. Athletes with low Hb or hematocrit (Hct) value and a characteristic history should be checked for iron deficiency. A normal ferritin level, iron level, and total iron-binding capacity (TIBC) confirms the diagnosis of dilutional anemia, or sports anemia, which does not need to be treated (Eichner, 1992; Shaskey and Green, 2000).

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