Can You Exercise With Anemia?

Anemia & Exercise


Anemia, also sometimes known as low iron, comes in various forms and has various causes. The iron molecule helps your red blood cells carry life-giving oxygen around your body. Without iron-carrying red blood cells circulating through our blood stream, our bodies die from lack of oxygen. Anemia due to iron deficiency can happen quickly, such as from rapid blood loss, or can happen gradually from losses, such as those with a menstrual period, from a slow loss within the bladder, or gastrointestinal tract.

We can also become anemic if our bodies do not make enough red blood cells due to inadequate intake of dietary iron or vitamin B12 or due to chronic issues with a poorly functioning bone marrow, which is where red blood cells are made. Exercise can sometimes increase the body’s need for iron and B12 due to increase use by our muscles. Some types of anemia pose greater health problems than others, depending on why and how quickly anemia occurs.

Symptoms of Anemia

  • Feeling tired or lack of energy
  • Higher heart rate – especially with exercise
  • Shortness of breath
  • Headaches
  • Poor endurance and stamina
  • Dizziness
  • Pale skin
  • Leg cramps
  • Insomnia/poor concentration

Exercising With Anemia

Women tend to be at a higher risk of developing anemia because of events such as heavy periods and pregnancy. Female athletes who engage in intense exercise on a regular basis are also at an increased risk of becoming anemic. However, aerobic exercises, such as swimming, running and biking, can help anemic women better deal with the condition.

The good news is that aerobic exercise allows for red blood cells to be delivered more efficiently to muscle tissue, but also causes an overall decrease in hemoglobin due to the dilution of red blood cells in plasma. The key to exercising with anemia is to find appropriate exercises that don’t drain you of all your energy but still provide aerobic and anaerobic benefits. Keep in mind, however, that if you are anemic, you should speak with your doctor about whether it is safe to exercise and if not when.

Exercise requires your body to use extra oxygen for the cells to work properly. If you are anemic when you exercise, you may develop lactic acidosis (when lactic acid builds ups in the bloodstream faster than it can be removed) and fatigue quickly, feel lethargic and feel a decrease in endurance. In addition, your recovery time may be longer and you will have more muscle stiffness that you would otherwise expect.

Foods To Improve Iron Levels

If you are diagnosed with anemia, there are some things you can do to quickly recover and be back in top shape for your workout. Foods such as spinach, eggs, soybeans, mussels, clams, oysters, beef and pork liver, and lentils are good foods sources of iron and sometimes B12. Adding a source of vitamin C, such as a citrus fruit, at the time of your iron-enriched meal, can enhance the absorption of iron into your system.

Working With Your Doctor To Balance Anemia and Exercise

There are some supplements available over the counter to increase your iron levels, but it’s always a good idea to ask your doctor what’s best for you. Blood tests may be needed to determine the type of anemia you have. Other testing may be needed to determine if you are losing blood from somewhere in your body, or just not making enough – another reason to see your doctor to be sure. You may need to expect some follow up blood tests to be done to determine if your treatment plan has been successful, then you can get back to exercising full steam ahead!

Regular exercise can play a vital role in dealing with anemia and encourages a long and healthy life. Speak with your doctor about what type of exercise program you should take up if you have anemia.
Happy New Year and here’s to the best of your health!

Elizabeth Salada, MD MPH
Internal Medicine and Wellness

This Post Has 15 Comments

  1. I am suffering from anaemia ..all the times I feel week .. I feel depressed .. I used to take lots of pressure n panic ..and day by day i am getting healthy hair and skin became dull ..please help me out from all this

    1. Please consult a health care professional on what medications and treatments you can use to re-gain your strength and health.

    2. Have you had your thyroid levels checked? Some of your symptoms sound more like thyroid problems.(hair, nails, etc)

  2. if you’re long term anemia – as i am – go get your doctor to find out what type of anemia you’ve got, and whats causing it. They may not be able to do that, but in most cases they can. If its “simple” iron deficiency, then is either malabsorbtion, or bleeding in your gut and they can treat both of those. Also look at the alternative supplements – ferrous fumarate can be the easiest to take, but if you have problems with tablets ask to get it infused.
    In addition i have found getting your vit B and D levels checked; quite a few anemics can also be deficient in Vit D too.
    Getting the whole of your health and diet right will help with hair and skin too
    The main thing is to be open with your doctor on how youre feeling and how iron loss impacts your life.

  3. I’m anemic. At first the doctor wasn’t sure but decided to take a blood test after I sat up from laying down and was extremely light headed (that and the fatigue depression weight loss and brain fog caused me to see him) it first showed up barley anemic not enough to cause the symptoms he said. He checked my vitamin b12 levels and they were also barley low. So he gave me a prescription for a supplement and told me to come back in a month. During that month I checked all ingredient labels of the foods I was suddenly craving more than usual for a couple months before I saw my doctor and they were high in iron and vitamin b12. I eat 6 or 7 meals a day yet when I grew from 5,8 to 6,2 I lost 40lbs no change in diet or my intense exercise from package handling at fedex for 6 hours straight no breaks 5 days a week. I love oranges and eat 3 or 4 a day plus I started to crave chicken and steak the nutrition bars I was eating also had 25% of your daily value I ate 4 a day giving me at 142.7lbs 100% of my value from those alone. We then found out that my family has a history of peptic ulcers and indeed I had one that he thought was micro bleeding causing all my symptoms and explaining why even after starting the supplement my levels did not change a bit.
    At my work I unload trailers alone or with 1 other person that have usually 2000 to 3000 packages in them all varying sizes and weights from 5lbs to 150lbs and no you don’t team lift you just gotta go as fast around 40-70 minutes per trailer is wanted. A negative number means you unloaded it fast and I did good getting -30 a trailer but suddenly when usually I would not sweat or feel sore until trailer 5 or 6 (5 or 6 is what I would do a day) I suddenly am sore after 1 or 2 trailers and pulling -5 0 or even worse I got a +5 today. I’m always tired I can no longer run a mile in 6:50 it takes 8 to 9 minutes and it no longer winds me it feels like I got run over by a bus or something. I’m starting to improve bit by bit with the anti biotics and ulcer medication but this has been going on for 5 months now I’m depressed not entirely there either sleeping too much or hardly at all my body aches all the time I feel sick I feel exhausted getting out of bed I get light headed a lot but I finally for the first time during these 5 months gained some weight 10 lbs. as I’m pushing myself to the absolute maximum and eating lots and lots and lots of protein I do not want to loose this job as its the first I ever loved it’s like going to the gym 5 to 7 hours a day but you get paid. I’m male and 18 yrs old. I constantly say I’m too young for this sh*t because I am.
    Is there anything than what I’m doing now that could help me out?
    Also I sun bathe without sunscreen 20 minutes a day and I’m still as white as a white crayon.
    I went from best shape I could ever be in to underweight sick and depressed. Seriously is there anything more I can do??? ANYTHING?

    1. Tyler, these issues are really out of our jurisdiction. You need to continue to see your doctor and focus on recovering. Your body seems to be weak. Give it time to rest.

  4. Im Anemic. 6 months ago i started a diet to lose weight. I had my period, a heavy one and in spite of that i continued my diet i was walking 4 to 5 km a day. My period hasn’t came since then. I almost fainted 3 days ago. I went to the doctor and she said that i should start eating normally again, but i don’t want to gain all the weight back and i really dont know if i should continue exercising ?? So what’s your advice

    1. Voice those same concerns you just wrote here to your doctor. If you aren’t comfortable with talking to your doctor, then find a new one.

  5. I’ve only just been diagnosed with anemia but i think i had it for quite a while. My question is related to heart rate training zones. Which is better for this condition : short periods of aerobic (70% to 80%) exercise or longer periods in the recovery zone (60% to 70%)? or perhaps some combination of these two…? thanks in advance.

    1. Thanks for reaching out with your question about anemia and exercise. The fact is that we you are anemic, your red blood cells can’t carry as much oxygen to your muscles. This results in your heart and other muscles not being as able to perform aerobic ( with oxygen) activities as well so you may get short of breath more easily, feel more fatigued faster and have less endurance. Your heart rate has to compensate for the lack of oxygen by beating faster, both at rest and during exercise, in order to get more oxygen to your cells faster. You may reach your maximum heart rate faster and with less effort when you are anemic. It won’t really matter if you exercise in your target heart rate or not in terms of treating the anemia. You just may notice that you can’t do what you normally would in terms of effort when you are anemic. It’s not harmful to exercise to your target heart rate when you are anemic unless you have coronary artery disease or lung disease. You just won’t feel as well and will be more prone to a higher heart rate faster when you are anemic. As your anemia improves, you should feel better during exercise and be less winded and less easily fatigued. If you don’t start to feel better in a few weeks a visit with your doctor for more blood work might be helpful.

      Thanks again for a great question!
      Take care
      Dr Salada

  6. Got blood test results back today and my doctor was very concerned. I am 4 pints low on blood and my red blood count was 7.5. She increased my iron intake from 150 to 300 mgs of polyiron and has me on b-12 as well. Because I am still menstruating, I have to see my gynecologist as she said another heavy period could land me in the hospital with an emergency transfusion. Is there any type of exercise that I can do to keep my muscles moving?

  7. I was just diagnosed with chronic anemia. I’m 28 year old women. Two months ago when an ER doctor looked at my blood draw she noticed severe low iron levels, a 7. She peaked and blood draws dating as far back as when I was twelve (the ER is linked with my local office I go to so she had access). Apparently, every draw showed the same low iron levels, but no one ever told me!
    I’m working with a new doctor and getting it sorted but now I’m wondering if things I’ve experienced all my life are because of this.
    When I lift weights or heavy tools in the garden my hands will shake for ages after. My face gets super read, except right around my lips which goes pale. I sweat alot and have trouble feeling like I’m getting enough air.
    Does anyone else experience any of these symptoms?

    1. I’m getting that feeling after a 35 minute workout. Shaking pretty bad when I stand up.

    2. Yes, anaemia causes all those things! Speak with your doctor to get the right prescription and within 2-3 weeks those symptoms will start fading and 3-6 months you’ll feel totally normal again!

  8. I knew that I have anemia when I doing a medical checkup to enter university in 2016 but I think I got it long before I knew it. My first result is 5.6 and after got infusion it reached to 6.6 (check at hospital). Last year I check it has reached to 12 (check at clinic but the clinic send the blood to a lab which is I don’t know where is it). I don’t have thyroid base from the result. I think I have iron deficiancy anemia from heavy bleeding but what I don’t understand is bacause is not every month I got it. Sometimes heavy for months, sometime none at all, sometime for months but little and sometime on off for months.

    The thing is I still feel tired, my body muscle ache and sore all the time especially after waking up or doing very simple thing. My hair are rough and thin. My skin are not pale as before but still not my usually colour. My lips, my gums and inside eyelids still pale but my nail are okay. I cannot lift heavy object, I cannot climb up the stair without panting, I cannot do work faster than before, I cannot concentred and always forgetting, I cannot walk fast and for a long distance without getting sore and swell feet. I cannot do any exercise and sports because I’m tired all the time. My knee always hurt especially if I stand for too long, have a little bit heavy backpack or bouncing a little. My knee and shoulder blade always have pop sound. And my tummy are big maybe from the fat and my cholestrole are high despite my thin body.

    Many people don’t understand especially my father and even the doctor. The doctor said it is not possible because I am young (now 22) and asked me to eat and live a healthy life style. Its hard to do that when you always busy from studying and doing other things that not necessary but need to do. The thing I hate the most is when people don’t know anything said that I am weak and when they knew the problem but don’t want to acknowledge it. I also hate when sometimes I told to others medical practictioners and they ask so many things and judged me because I don’t know about my own detail of this ‘disease’. I don’t always go to doctor especially specialist because its too pricey.

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