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Iron deficiency (ID) in nonanemic athletes has become more prevalent, creating a need to investigate the relationship between iron supplementation and iron deficiency in female athletes who are not anemic. The objective of this systematic review was to determine the impact of iron supplementation on athletic performance in iron-deficient, nonanemic (IDNA) female athletes. The search strategy was conducted in February 2022 using PubMed and CINAHL databases. Nine records that focused only on IDNA female athletes were included in the review, with a total of 355 female participants. The inclusion criteria were adult female athletes found to be IDNA. Iron supplementation of any form, dose, or duration and athletic performance measures were used. The exclusion criteria included adolescents, being injured, consuming other supplements or medications, or not measuring athletic performance. Five studies in this review concluded that iron supplementation improved iron status and enhanced physiological adaption. However, the other studies found that iron supplementation did not affect training. Some limitations in the studies reviewed include small sample size, shorter training duration, broad training regimens, exercise protocol, and measurement timing. Further determination of the level at which iron supplementation should be considered for female athletes who are IDNA is warranted. [ABSTRACT FROM AUTHOR]

Despite a high frequency of iron deficiency in pregnancy, the United States Preventative Services Task Force (USPSTF) stated: "there is inconclusive evidence routine supplementation for iron deficiency anemia improves maternal or infant clinical health outcomes." In contradistinction, high-quality epidemiologic studies report long lasting deficits in infants diagnosed with iron deficiency in the first 6 months of life compared with infants who were not, with specific deficits in cognition, memory, executive function and electrophysiology documented up to 19 years of age. Infants are not routinely screened for iron deficiency. United Kingdom guidelines differ and recommend screening high-risk infants who are preterm, of diabetic, underweight, obese, or vegetarian mothers, those born to anemic or iron deficient mothers, of smokers, those with inflammatory bowel disease or abnormal uterine bleeding, and from pregnancies in which the intergravid period is <6 months. Iron parameters are not routinely drawn unless anemia is present and in some cases only if microcytic. In that iron deficiency precedes the development of anemia, and waiting for its development misses a large number of overtly iron deficient gravidas. Iron parameters were measured in 102 consecutive, nonselected, nonanemic, first trimester women presenting to their obstetricians. Using standard cutoffs of percent transferrin saturation and/or serum ferritin, 42% were observed to be iron deficient. Given the lack of harm of testing for iron deficiency, it appears prudent to err on the side of caution and screen all presenting pregnant mothers until properly powered outcome data become available. The current recommendations of the USPSTF may need to be revisited. [ABSTRACT FROM AUTHOR]

Objective: Iron deficiency anemia (IDA) is a well-known cause of secondary restless legs syndrome (RLS). Iron deficiency without anemia (IDNA) is insidious, and its association with RLS is less evaluated. We investigate prevalence and features of IDNA in a consecutive cohort of patients with RLS.Methods: We included sequential primary RLS patients and RLS patients with IDA. We also recruited age- and gender-matched healthy controls. RLS mimics and other comorbidities were carefully excluded.Results: One-hundred and ninety-six RLS patients without anemia, 26 RLS patients with IDA, and 63 controls were included. 42.3% of RLS patients without anemia had iron deficiency. Women were much more susceptible for IDNA with a relative risk of 5.51 (p < 0.0001). Women with IDNA and RLS had younger age both at interview and at RLS onset compared to women with RLS without iron deficiency (NID) (P < 0.01). IDNA RLS patients showed a tendency to higher risk of severe/very severe tiredness or sleepiness during the day as compared to NID RLS patients. Furthermore, IDNA RLS patients had longer duration of RLS (P < 0.01 in men, P < 0.05 in women) and younger age at onset (only in men, P < 0.05) compared to IDA RLS patients.Conclusion: IDNA is frequent in RLS and iron deficiency may be severe despite a normal hemoglobin level. Women are at much higher risk for IDNA, and IDNA in women presents some specific clinical features. Features of IDNA RLS are different from IDA RLS. Regular screening of peripheral iron parameters even in patients with normal blood counts is recommended for timely optimal management.

Objective: Iron deficiency anemia (IDA) is a well-known cause of secondary restless legs syndrome (RLS). Iron deficiency without anemia (IDNA) is insidious, and its association with RLS is less evaluated. We investigate prevalence and features of IDNA in a consecutive cohort of patients with RLS. Methods: We included sequential primary RLS patients and RLS patients with IDA. We also recruited age- and gender-matched healthy controls. RLS mimics and other comorbidities were carefully excluded. Results: One-hundred and ninety-six RLS patients without anemia, 26 RLS patients with IDA, and 63 controls were included. 42.3% of RLS patients without anemia had iron deficiency. Women were much more susceptible for IDNA with a relative risk of 5.51 (p < 0.0001). Women with IDNA and RLS had younger age both at interview and at RLS onset compared to women with RLS without iron deficiency (NID) (P < 0.01). IDNA RLS patients showed a tendency to higher risk of severe/very severe tiredness or sleepiness during the day as compared to NID RLS patients. Furthermore, IDNA RLS patients had longer duration of RLS (P < 0.01 in men, P < 0.05 in women) and younger age at onset (only in men, P < 0.05) compared to IDA RLS patients. Conclusion: IDNA is frequent in RLS and iron deficiency may be severe despite a normal hemoglobin level. Women are at much higher risk for IDNA, and IDNA in women presents some specific clinical features. Features of IDNA RLS are different from IDA RLS. Regular screening of peripheral iron parameters even in patients with normal blood counts is recommended for timely optimal management. [ABSTRACT FROM AUTHOR]