Runner’s Anemia: 7 ways to increase your iron

Title image: Text over picture of foods that contain iron

Low iron levels can leave you feeling weak and tired. It can also lead to difficulty concentrating, lower immune systems, gastrointestinal upset, and make it harder to regulate body temperature. Symptoms runners tend to avoid. 

In this article, you’ll learn strategies to avoid runner’s anemia. Lifestyle changes can make the biggest impact on Iron-deficiency anemia and vitamin-deficiency anemia.

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Who is at risk?

Although runners are not considered to automatically be “high risk” for developing anemia, low iron levels occur often. Especially for women of reproductive age and during pregnancy. Frequent blood donors are also at risk of developing iron deficiency. 

7 ways to increase your iron to avoid runner’s anemia

  1. Add iron-rich foods into your diet

This may seem obvious, but being more intentional about what you eat can make a difference. Iron from animal sources (aka heme iron) is absorbed the best by the body so eating meat can make a big impact. Specifically, lean meat and seafood have the best source of heme iron. 

However, there is also a decent amount of iron in many plants (aka non-heme iron). Beans, lentils, dark leafy greens, and nuts are all good sources of non-heme iron. So it’s best to get a variety of these foods in your diet as well. Fortified breads and breakfast cereals also contain a lot of non-heme iron. 

  1. Pair your iron with vitamin C

Vitamin C helps increase absorption of iron by the body. Tomatoes, oranges, lemons, limes, kiwi, broccoli, cabbage, cauliflower, bell peppers, and strawberries are high in vitamin C. 

Choose one or two of these foods to eat about the same time as your meat or beans and you’ll get more out of your iron. For example, a salad might include leafy greens, chickpeas, grilled chicken, strawberries, and a squeeze of lemon juice plus dressing. 

  1. Get enough vitamin B12 and folate

A common cause of vitamin-deficiency anemia is low B12 and/or folate. Vitamin B12 is important for forming red blood cells and helps with the development of brain and nerve cells. Folate helps form DNA and is involved in protein metabolism.

Meat, fish, eggs, dairy, and fortified foods contain B12. While dark leafy green vegetables, beans, peanuts, sunflower seeds, fruits, and eggs have folate. 

  1. Use cast iron

Some iron is transferred to the food when it is cooked in cast iron. This increases the amount of iron consumed. Cast iron skillets can be used to make many dishes, including meat, sautéed vegetables, or combination dinners. 

  1. Try an iron fish

If you aren’t able to use a cast iron skillet because of the type of stove top you have, or due to the heavy weight of the skillets, try an iron fish. Iron fish are small fish made of iron that can be put in your pot while cooking other foods. 

Often used in soups, or while boiling water for noodles, this method is similar to using cast iron because it works by leaving some iron in the food/water while cooking. Remove the fish before serving, pat it dry, and store it as directed! This tip is especially good for vegetarians who are trying to avoid runner’s anemia without meat.

  1. Be smart with calcium

Calcium may decrease absorption of iron. If you enjoy milk, yogurt, or cheese along with your meat or beans, don’t worry too much about it as there is still debate on this. However, if you take a calcium supplement, I would recommend spacing it out from your main meal or take it at a different time of day from an iron supplement. 

  1. Take an iron supplement

A supplement may be recommended if your iron levels are very low. And sometimes, this is the best way to increase your iron quickly. Once iron levels are back to normal, you can talk to your doctor about when it’s time to stop a supplement. 

If you are concerned about the potential GI side effects of an iron supplement, look for an iron-amino acid chelate, carbonyl iron, or heme-iron polypeptides as these may be absorbed better and cause fewer issues. 

How much iron is needed?

The recommended dietary allowance, or RDA, for iron is 18 mg/day for women ages 19-50 years, 27 mg/day for women who are pregnant, and 9 mg/day for women who are lactating. The RDA is 1.8 times the amounts above for vegetarians. 


If you feel you might have runner’s anemia it’s best to get your iron checked by your primary care physician. If your iron level is normal, but you’ve been feeling tired after working out you may be under fueling in other ways. A dietitian can help you figure out any changes you may need to make to your diet to maximize performance and energy levels.

This information is for educational purposes only and is not meant to be a substitute for medical treatment or diagnosis. You should consult with your doctor before changing your diet or starting supplements for any health condition.

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