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Iron Regulation at Altitude: An Investigation into the Influence of Acute Exposure, Chronic Responses, and Best Practice Supplementation

Iron deficiency is a common diagnosis in endurance athletes and because of an accelerated erythropoietic drive is more common in those training and competing at altitude. If left untreated, reduced iron stores may adversely affect endurance performance, resulting in lethargy, undue fatigue, and reduced physical work capacity. Currently, the current understanding of the mechanisms underlying post-exercise iron is poor and no clear best practice iron supplementation guidelines exist. Therefore, medical staff, nutritionists and physiologists can provide limited information regarding iron supplementation strategies for altitude training.

This project will investigate the mechanisms regulating post-exercise iron metabolism in response to intermittent hypoxic training (Study 1) acute and chronic Live High, Train Low altitude exposure (Study 2), and compare the efficacy of oral v intravenous iron supplementation during chronic Live High, Train Low altitude exposure (Study 3). Specifically, Study 1 will employ a repeated measures design to investigate how high intensity interval exercise performed in hypoxic and normoxic conditions influences post- exercise hepcidin, inflammatory cytokine (IL-6) activity and subsequent iron status. Study 2 will examine the influence of weekly high intensity interval exercise on hepcidin, IL-6 and erythropoietic activity during the post-exercise recovery period in response to 21 days of Live High, Train Low altitude exposure. 

Finally, Study 3 will compare how oral v intravenous iron supplementation influences resting and post-exercise hepcidin, IL-6 and erythropoetic activity in response to 21 days Live High, Train Low altitude exposure. The outcomes of this project will play a significant role in enhancing our understanding of post-exercise iron metabolism at altitude, allowing for development of “best practice” iron supplementation guidelines in such environments. Therefore, these outcomes may prevent the incidence of iron deficiency and assist the repletion of iron stores in athletes travelling to, or training at altitude.

Project duration



Mr Andrew Govus
Associate Professor Chris Abbiss
The University of Western Australia (Aus), Dr Peter Peeling
Australian Institute of Sport (Aus), Dr Laura Garvican
Australian Institute of Sport (Aus), Professor Chris Gore

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