The Global Prevalence of Iron Deficiency in Collegiate Athletes: A Systematic Review and Meta-Analysis.

Athletes are at high risk of iron deficiency even without anemia. In this systematic review and meta-analysis that included 17,519 athletes in 122 references from 23 countries, participating in 62 unique sports over a 41-year timeframe, approximately 53.9% of student-athletes were found to be hypoferritinemic (ferritin concentration below 50 mcg/L) with 23.0% percent showing absolute iron deficiency based on current definitions (ferritin concentration below 20 mcg/L). These findings strongly suggest that changes in clinical practice guidelines are warranted to enable routine screening for iron deficiency among adolescent and collegiate athletes.