Engaging in moderate to intense physical activity has been demonstrated to trigger hematological alterations, among which anemia is one of the most common and clinically relevant conditions. This condition is marked by a decrease in hemoglobin concentration within blood, leading to impairing oxygen transport and consequently diminished physical performance. Anemia in athletes, can be attributed to a variety of factors, including exercise- induced hemolysis, gastrointestinal or urinary losses, iron deficiency, and nutritional inadequacies.

This study aimed to review the scientific literature concerning the mechanisms, diagnosis, and management of anemia in physically active individuals and athletes across various disciplines.

This is a narrative literature review is based on bibliographic research conducted through the following databases PubMed, SciELO, LILACS, and Google Scholar. A comprehensive selection of articles published between 2010 and 2024 was made available selected in Portuguese, English, and Spanish. The descriptors employed included: The following terms must be defined: “sports anemia,” “iron deficiency,” “hemoglobin,” “physical activity,” and “athletic performance”.

Iron deficiency anemia is the most prevalent form among athletes, particularly in women, long-distance runners, and endurance athletes. The primary etiological factors contributing to this condition include an augmented demand for iron, losses through perspiration, gastrointestinal microbleeding, and mechanical hemolysis resulting physical exertion, particularly in the lower limbs during running. It is important to note that sports anemia may also be confused with athlete’s pseudoanemia, a physiological condition resulting from plasma volume expansion without actual reduction in red cell mass. A differential diagnosis is crucial and involves laboratory tests such as a complete blood count, serum ferritin, transferrin saturation, and hemoglobin levels. Discussion: Anemia has been demonstrated to have a detrimental effect on athletic performance and may also compromise overall health. Early identification and appropriate treatment, with a focus on nutritional strategies and supplementation, are essential for performance recovery. Interdisciplinary collaboration among health professionals, including physicians, nutritionists, and physical educators, is vital for prevention and management. Conclusion: In the domain of sports medicine, anemia is a multifactorial condition that necessitates particular consideration during clinical evaluations of athletes. A review of the extant literature indicates early interventions and individualized approaches are associated with improved physical performance enhanced health maintenance. Investments in education, periodic screening, and nutritional support are fundamental measures in the routine care of both professional and amateur athletes.