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Swimming and Anemia

Eating- a swimmer's second favorite thing to do in life! We like to talk about food. We like to chatter about what sounds good to eat before we swim, we dream about it during practice and discuss what we would like to eat as we leave the pool. Though somehow in the shuffle of cravings, the basic concept of food as fuel gets lost.

Maintaining a healthy diet to balance the strenuous workouts expected to compete is it's own training challenge. And as every swimmer or swim parent knows, combining the right caloric intake and nutritional balance isn't easy. A quick solution to immediate, post practice hunger doesn't have to be traditional, but it should be healthy or nutritious. Not taking the time to do so can lead to vitamin and mineral deficiency. Worst case scenario those choices can also contribute to the development of anemia.

What is Anemia

Anemia is when your body either doesn't have enough healthy red blood cells or your red blood cells aren't functioning properly. There are several types of anemia, these are the two most common-

Iron Deficiency Anemia- This occurs when you do not have enough iron in your body due to diet, body changes, blood loss, or gastrointestinal tract abnormalities.

Vitamin Deficiency Anemia- May result when you have low levels of B12 or folic acid. This type of anemia is typically due to poor diet.

Iron and sports.

Iron deficiency is a common problem for athletes, especially female athletes. That is not to say men aren’t at risk for iron deficiency or anemia just not at the same correlation.

Iron is the key component to athletic performance success. It is iron that transports oxygen to your cells and carries carbon dioxide away. It is not just your body but your brain that also relies on iron for oxygen transport.

Imagine not having enough oxygen and trying to swim! Sprinting would be challenge enough, but what if you are a middle distance swimmer?

A combination of factors place swimmers at risk

  • Inadequate vitamins, minerals or iron in their diet. Swimmers who eat a plant based diet are at greater risk of iron deficiency.

  • Vigorous training increases the body's demand for red blood cells and increases the demand for iron, especially for high intensity endurance athletes.

  • Blood loss, whether due to injury or menstruation.

  • Sweating! Iron is lost during sweating. Heavy sweating leads to increased risk of deficiency.

It is believed that in the United States 10 million people are iron deficient and at least 5 million people have developed iron deficiency anemia. It is an illness too often overlooked and discounted by modern diagnosis. My own diagnosis took twenty years to finally receive. By then my sports career was long over, and I was just plain old sick. Anemia symptoms are sly. They slowly overcome you. All athletes and coaches should be aware of the symptoms of vitamin deficiency and anemia. These types of illnesses can have serious long term effects in and out of the pool.

Symptoms of Anemia

Brittle nails

Dizziness or lightheadedness- especially going from sitting to standing

Shortness of breath. Sometimes confused with stress or anxiety because it seems like a long sigh

Always cold- especially your hands or feet

Overall weakness

Pounding or "whooshing" in your ears

Extreme exhaustion. Not just being a little tired from practice but you can't stay awake


Sore and achy legs or feet

Inflammation or soreness on your tongue

Sore throat or gagging feeling in the back of your throat

Sore neck and shoulders

Headaches and tension headaches

Muscle cramps

Diarrhea or stomach cramps


Increased or fast heart beat.


Chest pains

Normal iron levels range between 30 percent and 45 percent but premenopausal women should be near 50 percent. It is possible to be within normal levels and still symptomatic.

  • Foods that help maintain iron levels

  • Animal products- lean beef, poultry, fish, eggs, and liver.

  • Fortified Cereals- grits and Cream of Wheat are both high in iron.

  • Legumes and nuts such as cashews, pumpkin seeds, beans, chickpeas, soybeans, black beans, lentils, and sesame seeds.

  • Combining foods high in Vitamin C with Iron rich foods will help increase your absorption.

One of the major factors to stiving off anemia and vitamin deficiency is the food that we eat. Every day we make food choices that impact our overall health. This is about perspective. As swimmers we spend hours deciding on the tech suit we buy or the type of goggles we use but eat on a whim. Athletes must learn to eat with intent. Choosing food as fuel as opposed to something quick or convenient is as important as the yardage you put in each practice. It may be more important because you can’t get sick from not swimming enough laps but you can if you don’t eat right.

Getting Diagnosed

If you are experiencing any symptoms or are curious about your vitamin, mineral or iron levels contact your family physician or team doctor. Remember many symptoms are similar to over-training or other illnesses. Anemia should not be self diagnosed but is done with a blood test.

If you have any additional questions or concerns you can contact :

The American Society of Hematology

2021 L Street NW, Suite 900, Washington, DC 20036

Phone 202-776-0544 | Fax 202-776-0545


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