It's estimated one in three female athletes have an iron deficiency, compared to one in 10 males. Rugby union player Sally Fuesaina experienced excessive fatigue before she was diagnosed with the condition.
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00:00I could be on the field trying to move around, but there's not enough blood and oxygen flowing
00:10in my body for me to perform well.
00:14Sally's a 32-year-old mum with two kids who works part-time, then makes a five-hour round
00:20trip from Sydney several times a week to play and train for the Brumbies.
00:24Her constant fatigue didn't come as a surprise, but it wasn't until she was pregnant with
00:29her first child that a routine blood test showed the cause was more serious.
00:33They did tell me I had really low iron and that if I don't stay on top of it, I would
00:40need an iron infusion, and I didn't stay on top of it, so I did have to get an iron infusion.
00:46I was like, is that why I'm sleeping all the time?
00:49After training sessions, it wasn't normal how I was really tired.
00:55Iron deficiency affects around 1 in 3 female athletes compared to 1 in 10 male athletes.
01:01Alana McKay has been studying the issue, including this staggering discrepancy, for eight years.
01:07We lose iron when we menstruate, so every time we have a period, we have blood loss
01:11which is associated with iron loss.
01:13A lack of iron impairs red blood cell production and therefore an athlete's aerobic capacity
01:18and fitness, but Dr McKay says athletes are often confused about the warning signs.
01:23They're always feeling tired.
01:24If they have families at home, they're always tired.
01:26If they're training multiple times a week, they're always tired and they don't always
01:29attribute that symptom towards iron deficiency.
01:33It's not just elite athletes who can be affected by low iron stores, as people who exercise
01:37frequently are also susceptible.
01:40Exercise has a really big impact on the way our body regulates iron, so it causes some
01:45hormonal disruptions that limit the ability for us to absorb iron from the diet for about
01:50six hours after we exercise.
01:53With normal fatigue symptoms often going unnoticed, she suggests anyone who exercise
01:58regularly get screened at least twice a year.
02:00Anthea Moody, ABC News, Canberra.