{"id":630038,"date":"2024-10-15T09:30:50","date_gmt":"2024-10-15T13:30:50","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=630038"},"modified":"2025-06-03T14:00:46","modified_gmt":"2025-06-03T18:00:46","slug":"exercise-induced-anemia","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/exercise-induced-anemia\/","title":{"rendered":"Can exercise make you anemic?"},"content":{"rendered":"

Anemia<\/span><\/a> develops when you don\u2019t have enough <\/span>red blood cells<\/span>. When this happens, your body doesn\u2019t circulate adequate oxygenated blood, which can lead to<\/span> symptoms<\/span> like feeling weak, dizzy, and fatigued. The CDC estimates that<\/span> 2.8 million people<\/span> in the U.S. have anemia.<\/span><\/p>\n

If you are a high-intensity athlete or someone <\/span>who<\/span> exercises frequently, you might wonder: Can exercise cause anemia? Though rare,<\/span> exercise-induced anemia<\/span>, or <\/span>sports anemia<\/span>,\u00a0 can occur among people <\/span>who<\/span> engage in intense <\/span>physical activity<\/span> regularly. Here, we\u2019ll take a closer look at this phenomenon\u2014what causes it, what symptoms to watch for, along with expert tips for how to manage and prevent it.<\/span><\/p>\n

Can exercise cause anemia?<\/span><\/h2>\n

Yes, it\u2019s possible for exercise to cause anemia. \u201cIntense or prolonged exercise can lead to changes in <\/span>iron levels<\/span>, and in some cases, it can cause anemia, which is often referred to as \u2018<\/span>sports anemia<\/span>,\u2019\u201d explains Sean Ormond, MD, interventional pain management physician at <\/span>Atlas Pain Specialists<\/span>.<\/span><\/p>\n

Dr. Ormond, <\/span>who<\/span> treats athletes with various training-related issues (including exercise-induced anemia), says that the condition isn\u2019t extremely common, but it does occur in a noticeable number of athletes, particularly ones <\/span>who<\/span> engage in high-endurance activities such as running, cycling, and swimming. \u201cThe <\/span>prevalence<\/span> can vary based on the type and intensity of the sport, as well as <\/span>dietary<\/span> factors,\u201d he notes.<\/span><\/p>\n

Although there is scant research on the <\/span>prevalence<\/span> of exercise-induced anemia among athletes of all types and demographics,<\/span> a study<\/span><\/a> looking at 1190 athletes found that up to 20% of them had anemia. Anemia was most likely to strike younger athletes and <\/span>female athletes<\/span>.<\/span> Research <\/span><\/a>\u00a0found that 28% of female marathon runners had anemia.<\/span>\u00a0<\/span><\/p>\n

Causes of exercise-induced anemia<\/span><\/h2>\n

There are several different ways that exercise can induce anemia. Let\u2019s take a look at some of the most <\/span>common causes<\/span> of exercise-induced anemia.<\/span><\/p>\n

Hemolysis<\/span><\/h3>\n

Hemolysis<\/span><\/a> refers to the breakdown of <\/span>red blood cells<\/span>. If <\/span>red blood cells<\/span> are broken down at the same rate that the body makes red blood cells, the patient will not be anemic. If the body breaks down red blood cells too quickly, you won\u2019t have enough <\/span>red blood cells<\/span> or <\/span>hemoglobin<\/span> in your body, causing anemia. Sometimes exercise can cause excessive <\/span>red blood cells<\/span> to be broken down.<\/span><\/p>\n

This is often due to the repetitive physical impacts that can happen during exercise. \u201cOne major factor is the destruction of <\/span>red blood cells<\/span> due to the repetitive impact (especially in runners, hence \u2018runner\u2019s anemia\u2019), where the cells burst from the constant pounding of the feet against the ground,\u201d Dr. Ormond explains.<\/span><\/p>\n

Gastrointestinal bleeding<\/span> and sweating<\/span><\/h3>\n

Sometimes exercising can cause bleeding in your GI tract. \u201cWhen exercising intensely, someone can have minor GI bleeding, so with a loss of blood, your labs may be positive for anemia,\u201d says <\/span>Danielle Kelvas, MD<\/span><\/a>, a primary care physician based in Tennessee. It\u2019s also possible to lose very small amounts of iron as you sweat, she adds.<\/span><\/p>\n

Hematuria<\/span><\/h3>\n

Hematuria<\/span><\/a> is when there\u2019s blood in your urine. Blood in the urine can be microscopic, such that the urine will not appear pink or red, but is still losing red blood cells nonetheless. According to a<\/span> narrative review<\/span><\/a>, one cause of exercised-induced anemia is hematuria. This is most likely to happen in runners <\/span>who<\/span> experience bladder contusions as a result of the impacts of running. The athlete may be unaware that the bladder is hitting against the pubic bone. <\/span>Other research<\/span><\/a> has pointed to possible microscopic lesions developing in the urinary tract due to reduced circulation to your organs during high-<\/span>intensity exercise<\/span>, resulting in <\/span>blood loss<\/span> and <\/span>iron loss<\/span>.<\/span><\/p>\n

Increased <\/span>hepcidin<\/span> concentration<\/span><\/h3>\n

Exercise temporarily increases the concentration of<\/span> hepcidin<\/span><\/a>, a hormone that regulates the <\/span>body\u2019s iron<\/span> metabolism. \u201cIf <\/span>hepcidin<\/span> concentration increases briefly, then your blood concentration of iron decreases,\u201d Dr. Kelvas explains. \u201cWe call this iron-restrictive anemia.\u201d<\/span><\/p>\n

Over-exercising<\/span><\/h3>\n

Overexerting yourself can cause you to burn excessive calories and nutrients, and if you aren\u2019t properly replenishing, you may develop nutritional deficiencies like anemia. For instance, \u201coverexercising in the setting of not eating enough protein and iron can result in anemia,\u201d Dr. Kelvas says.<\/span><\/p>\n

Inflammation<\/span><\/h3>\n

Endurance athletes<\/span> or those <\/span>who<\/span> exercise intensely may experience upticks of <\/span>inflammation<\/span><\/a> in the body. This can lead to anemia for some people, says <\/span>Kevin Huffman, DO<\/span><\/a>, doctor of osteopathic medicine and founder of<\/span> American Bariatric Consultants. \u201c<\/span>Iron absorption<\/span> can also be disturbed by inflammation associated with exertion,\u201d Dr. Huffman explains.<\/span><\/p>\n

Symptoms of exercise-induced anemia<\/span>\u00a0<\/span><\/h2>\n

Symptoms of exercise-induced anemia are the same symptoms as <\/span>iron deficiency anemia<\/span>. \u201cSymptoms can include fatigue, weakness, dizziness, <\/span>shortness of breath<\/span>, and reduced exercise performance,\u201d says Dr. Ormond.<\/span><\/p>\n

Oftentimes anemia is asymptomatic, especially at first. When it has symptoms, <\/span>iron deficiency anemia<\/span> can affect many areas of your body. Some of the possible<\/span> symptoms of anemia<\/span><\/a> include:<\/span><\/p>\n