Iron deficiency in young basketball players: Is a 100 g/L ferritin cut-off appropriate for iron supplementation?: Results of a randomized placebo-controlled study

Background: Iron deficiency (ID) is one of the most common factors that may reduce sports performance, supplementation forms and doses are still not standardized in athletes. Our aim was to assess the iron status of young male basketball players and to study the effect of iron supplementation in a randomized placebo-controlled study. Hypothesis: We hypothesized that due to the higher iron demand of athletes, the 100 mu g/L ferritin cut-off may be appropriate to determine the non-anemic ID. Methods: During a sports cardiology screening, questionnaires, laboratory tests, electrocardiograms, echocardiography exams, and cardiopulmonary exercise tests were performed. Athletes with ID (ferritin <100 mu g/L) were randomized into iron and placebo groups. Ferrous sulfate (containing 100 mg elemental iron [II] and 60 mg ascorbic acid) or placebo (50 mg vitamin C) was administered for 3 months. All exams were repeated after the supplementation period. Results: We included 65 (age 15.8 +/- 1.7 years) basketball players divided into four age groups. Non-anemic ID was observed in 60 (92%) athletes. After supplementation, ferritin levels were higher in the iron group (75.5 +/- 25.9 vs. 54.9 +/- 10.4 mu g/L, p <.01). Ferritin >100 mu g/L level was achieved only in 15% of the athletes. There were no differences in performance between the groups (VO2 max: 53.6 +/- 4.3 vs. 54.4 +/- 5.7 mL/kg/min, p =.46; peak lactate: 9.1 +/- 2.2 vs. 9.1 +/- 2.6 mmol/L, p =.90). Conclusions: As a result of the 3-month iron supplementation, the ferritin levels increased; however, only a small portion of the athletes achieved the target ferritin level, while performance improvement was not detectable.