Four Weeks of IV Iron Supplementation Reduces Perceived Fatigue and Mood Disturbance in Distance Runners

Amy Woods, Laura GARVICAN, Philo Saunders, Greg Lovell, David Hughes, Ruth Fazakerley, Bev Anderson, Christopher Gore, Kevin THOMPSON

    Research output: Contribution to journalArticle

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    Abstract

    PURPOSE: To determine the effect of intravenous iron supplementation on performance, fatigue and overall mood in runners without clinical iron deficiency.

    METHODS: Fourteen distance runners with serum ferritin 30-100 µg · L(-1) were randomly assigned to receive three blinded injections of intravenous ferric-carboxymaltose (2 ml, 100 mg, IRON) or normal saline (PLACEBO) over four weeks (weeks 0, 2, 4). Athletes performed a 3,000 m time trial and 10 × 400 m monitored training session on consecutive days at week 0 and again following each injection. Hemoglobin mass (Hbmass) was assessed via carbon monoxide rebreathing at weeks 0 and 6. Fatigue and mood were determined bi-weekly until week 6 via Total Fatigue Score (TFS) and Total Mood Disturbance (TMD) using the Brief Fatigue Inventory and Brunel Mood Scale. Data were analyzed using magnitude-based inferences, based on the unequal variances t-statistic and Cohen's Effect sizes (ES).

    RESULTS: Serum ferritin increased in IRON only (Week 0: 62.8 ± 21.9, Week 4: 128.1 ± 46.6 µg · L(-1); p = 0.002) and remained elevated two weeks after the final injection (127.0 ± 66.3 µg · L(-1), p = 0.01), without significant changes in Hbmass. Supplementation had a moderate effect on TMD of IRON (ES -0.77) with scores at week 6 lower than PLACEBO (ES -1.58, p = 0.02). Similarly, at week 6, TFS was significantly improved in IRON vs. PLACEBO (ES -1.54, p = 0.05). There were no significant improvements in 3,000 m time in either group (Week 0 vs. Week 4; Iron: 625.6 ± 55.5 s vs. 625.4 ± 52.7 s; PLACEBO: 624.8 ± 47.2 s vs. 639.1 ± 59.7 s); but IRON reduced their average time for the 10 × 400 m training session at week 2 (Week 0: 78.0 ± 6.6 s, Week 2: 77.2 ± 6.3; ES-0.20, p = 0.004).

    CONCLUSION: During 6 weeks of training, intravenous iron supplementation improved perceived fatigue and mood of trained athletes with no clinical iron deficiency, without concurrent improvements in oxygen transport capacity or performance.

    Original languageEnglish
    Pages (from-to)1-11
    Number of pages11
    JournalPLoS One
    Volume9
    Issue number9
    DOIs
    Publication statusPublished - 2014

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    emotions
    Fatigue
    Iron
    Fatigue of materials
    iron
    athletes
    ferritin
    hemoglobin
    injection
    Ferritins
    carbon monoxide
    Athletes
    Hemoglobins
    intravenous injection
    statistics
    Injections
    oxygen
    Carbon Monoxide
    Serum
    Intravenous Injections

    Cite this

    Woods, Amy ; GARVICAN, Laura ; Saunders, Philo ; Lovell, Greg ; Hughes, David ; Fazakerley, Ruth ; Anderson, Bev ; Gore, Christopher ; THOMPSON, Kevin. / Four Weeks of IV Iron Supplementation Reduces Perceived Fatigue and Mood Disturbance in Distance Runners. In: PLoS One. 2014 ; Vol. 9, No. 9. pp. 1-11.
    @article{3625f95f67a94a57ab6b0236d72be0cd,
    title = "Four Weeks of IV Iron Supplementation Reduces Perceived Fatigue and Mood Disturbance in Distance Runners",
    abstract = "PURPOSE: To determine the effect of intravenous iron supplementation on performance, fatigue and overall mood in runners without clinical iron deficiency.METHODS: Fourteen distance runners with serum ferritin 30-100 µg · L(-1) were randomly assigned to receive three blinded injections of intravenous ferric-carboxymaltose (2 ml, 100 mg, IRON) or normal saline (PLACEBO) over four weeks (weeks 0, 2, 4). Athletes performed a 3,000 m time trial and 10 × 400 m monitored training session on consecutive days at week 0 and again following each injection. Hemoglobin mass (Hbmass) was assessed via carbon monoxide rebreathing at weeks 0 and 6. Fatigue and mood were determined bi-weekly until week 6 via Total Fatigue Score (TFS) and Total Mood Disturbance (TMD) using the Brief Fatigue Inventory and Brunel Mood Scale. Data were analyzed using magnitude-based inferences, based on the unequal variances t-statistic and Cohen's Effect sizes (ES).RESULTS: Serum ferritin increased in IRON only (Week 0: 62.8 ± 21.9, Week 4: 128.1 ± 46.6 µg · L(-1); p = 0.002) and remained elevated two weeks after the final injection (127.0 ± 66.3 µg · L(-1), p = 0.01), without significant changes in Hbmass. Supplementation had a moderate effect on TMD of IRON (ES -0.77) with scores at week 6 lower than PLACEBO (ES -1.58, p = 0.02). Similarly, at week 6, TFS was significantly improved in IRON vs. PLACEBO (ES -1.54, p = 0.05). There were no significant improvements in 3,000 m time in either group (Week 0 vs. Week 4; Iron: 625.6 ± 55.5 s vs. 625.4 ± 52.7 s; PLACEBO: 624.8 ± 47.2 s vs. 639.1 ± 59.7 s); but IRON reduced their average time for the 10 × 400 m training session at week 2 (Week 0: 78.0 ± 6.6 s, Week 2: 77.2 ± 6.3; ES-0.20, p = 0.004).CONCLUSION: During 6 weeks of training, intravenous iron supplementation improved perceived fatigue and mood of trained athletes with no clinical iron deficiency, without concurrent improvements in oxygen transport capacity or performance.",
    keywords = "fatigue, ferritin, hemoglobin, human performance, intravenous injections, iron deficiency, anemia, sports",
    author = "Amy Woods and Laura GARVICAN and Philo Saunders and Greg Lovell and David Hughes and Ruth Fazakerley and Bev Anderson and Christopher Gore and Kevin THOMPSON",
    year = "2014",
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    }

    Woods, A, GARVICAN, L, Saunders, P, Lovell, G, Hughes, D, Fazakerley, R, Anderson, B, Gore, C & THOMPSON, K 2014, 'Four Weeks of IV Iron Supplementation Reduces Perceived Fatigue and Mood Disturbance in Distance Runners', PLoS One, vol. 9, no. 9, pp. 1-11. https://doi.org/10.1371/journal.pone.0108042

    Four Weeks of IV Iron Supplementation Reduces Perceived Fatigue and Mood Disturbance in Distance Runners. / Woods, Amy; GARVICAN, Laura; Saunders, Philo; Lovell, Greg; Hughes, David; Fazakerley, Ruth; Anderson, Bev; Gore, Christopher; THOMPSON, Kevin.

    In: PLoS One, Vol. 9, No. 9, 2014, p. 1-11.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Four Weeks of IV Iron Supplementation Reduces Perceived Fatigue and Mood Disturbance in Distance Runners

    AU - Woods, Amy

    AU - GARVICAN, Laura

    AU - Saunders, Philo

    AU - Lovell, Greg

    AU - Hughes, David

    AU - Fazakerley, Ruth

    AU - Anderson, Bev

    AU - Gore, Christopher

    AU - THOMPSON, Kevin

    PY - 2014

    Y1 - 2014

    N2 - PURPOSE: To determine the effect of intravenous iron supplementation on performance, fatigue and overall mood in runners without clinical iron deficiency.METHODS: Fourteen distance runners with serum ferritin 30-100 µg · L(-1) were randomly assigned to receive three blinded injections of intravenous ferric-carboxymaltose (2 ml, 100 mg, IRON) or normal saline (PLACEBO) over four weeks (weeks 0, 2, 4). Athletes performed a 3,000 m time trial and 10 × 400 m monitored training session on consecutive days at week 0 and again following each injection. Hemoglobin mass (Hbmass) was assessed via carbon monoxide rebreathing at weeks 0 and 6. Fatigue and mood were determined bi-weekly until week 6 via Total Fatigue Score (TFS) and Total Mood Disturbance (TMD) using the Brief Fatigue Inventory and Brunel Mood Scale. Data were analyzed using magnitude-based inferences, based on the unequal variances t-statistic and Cohen's Effect sizes (ES).RESULTS: Serum ferritin increased in IRON only (Week 0: 62.8 ± 21.9, Week 4: 128.1 ± 46.6 µg · L(-1); p = 0.002) and remained elevated two weeks after the final injection (127.0 ± 66.3 µg · L(-1), p = 0.01), without significant changes in Hbmass. Supplementation had a moderate effect on TMD of IRON (ES -0.77) with scores at week 6 lower than PLACEBO (ES -1.58, p = 0.02). Similarly, at week 6, TFS was significantly improved in IRON vs. PLACEBO (ES -1.54, p = 0.05). There were no significant improvements in 3,000 m time in either group (Week 0 vs. Week 4; Iron: 625.6 ± 55.5 s vs. 625.4 ± 52.7 s; PLACEBO: 624.8 ± 47.2 s vs. 639.1 ± 59.7 s); but IRON reduced their average time for the 10 × 400 m training session at week 2 (Week 0: 78.0 ± 6.6 s, Week 2: 77.2 ± 6.3; ES-0.20, p = 0.004).CONCLUSION: During 6 weeks of training, intravenous iron supplementation improved perceived fatigue and mood of trained athletes with no clinical iron deficiency, without concurrent improvements in oxygen transport capacity or performance.

    AB - PURPOSE: To determine the effect of intravenous iron supplementation on performance, fatigue and overall mood in runners without clinical iron deficiency.METHODS: Fourteen distance runners with serum ferritin 30-100 µg · L(-1) were randomly assigned to receive three blinded injections of intravenous ferric-carboxymaltose (2 ml, 100 mg, IRON) or normal saline (PLACEBO) over four weeks (weeks 0, 2, 4). Athletes performed a 3,000 m time trial and 10 × 400 m monitored training session on consecutive days at week 0 and again following each injection. Hemoglobin mass (Hbmass) was assessed via carbon monoxide rebreathing at weeks 0 and 6. Fatigue and mood were determined bi-weekly until week 6 via Total Fatigue Score (TFS) and Total Mood Disturbance (TMD) using the Brief Fatigue Inventory and Brunel Mood Scale. Data were analyzed using magnitude-based inferences, based on the unequal variances t-statistic and Cohen's Effect sizes (ES).RESULTS: Serum ferritin increased in IRON only (Week 0: 62.8 ± 21.9, Week 4: 128.1 ± 46.6 µg · L(-1); p = 0.002) and remained elevated two weeks after the final injection (127.0 ± 66.3 µg · L(-1), p = 0.01), without significant changes in Hbmass. Supplementation had a moderate effect on TMD of IRON (ES -0.77) with scores at week 6 lower than PLACEBO (ES -1.58, p = 0.02). Similarly, at week 6, TFS was significantly improved in IRON vs. PLACEBO (ES -1.54, p = 0.05). There were no significant improvements in 3,000 m time in either group (Week 0 vs. Week 4; Iron: 625.6 ± 55.5 s vs. 625.4 ± 52.7 s; PLACEBO: 624.8 ± 47.2 s vs. 639.1 ± 59.7 s); but IRON reduced their average time for the 10 × 400 m training session at week 2 (Week 0: 78.0 ± 6.6 s, Week 2: 77.2 ± 6.3; ES-0.20, p = 0.004).CONCLUSION: During 6 weeks of training, intravenous iron supplementation improved perceived fatigue and mood of trained athletes with no clinical iron deficiency, without concurrent improvements in oxygen transport capacity or performance.

    KW - fatigue

    KW - ferritin

    KW - hemoglobin

    KW - human performance

    KW - intravenous injections

    KW - iron deficiency

    KW - anemia

    KW - sports

    U2 - 10.1371/journal.pone.0108042

    DO - 10.1371/journal.pone.0108042

    M3 - Article

    VL - 9

    SP - 1

    EP - 11

    JO - PLoS One

    JF - PLoS One

    SN - 1932-6203

    IS - 9

    ER -