Free Guide for Active Women
The Iron Bloodwork Checklist
How low iron might be ruining your performance — and why standard bloodwork keeps missing it. Here's what to test, watch for, and do.
This guide includes:
- How low iron is missed in so many females
- How low iron sabotages performance (& the symptoms to look out for)
- The 5 iron markers to request from your GP
- The correct iron target ranges for active women
- A step-by-step plan if your numbers come back low
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Who this is for
For active women, across every sport
Whether you run, lift, grapple, or train multiple sports — iron deficiency hits female athletes more than most doctors recognise.
Why this guide exists
Why 'within range' isn't the right range for female athletes
A 2025 systematic review found that up to 60% of female athletes experience iron deficiency — and that performance starts to decline long before anything shows up on a standard blood test.
We're talking a 3–4% drop in endurance, reduced aerobic capacity, and impaired strength and power output. All while your bloodwork still looks "normal."
The reason? Most standard tests only check part of the iron picture — usually just haemoglobin. And even when other markers are tested, the "normal" range is built for the general population, not active women.
About the author
Hi, I'm Sarah Tuohy
A registered sports dietitian based in Rotterdam. For the past 10+ years, sport has been a central part of my life — from weightlifting and HYROX to competing in Brazilian Jiu Jitsu internationally.
Women's health in sports has always been my main focus. Sadly, most performance research, lab reference ranges, and clinical advice were built on men — and the gap in female-specific research still leaves a lot of guesswork and trial-and-error.
Across years of coaching 500+ clients — and in my own training — I keep seeing the same story: active women told their bloodwork is "normal" while they're clearly struggling. This checklist is the resource I wish every female athlete had before walking into their next appointment.
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What athletes say
“If it hadn't been for Sarah, I would not have been the athlete that I am. Sarah is incredibly precise in the way she works, very structured and makes me a part of the process as much as she is. I love her work ethic, passion and she is generally just a great person to work with. I have recommended her to many others who all have had as much positive experiences as me, and I will continue to recommend her!”
Rose El Sharrouni
BJJ blackbelt & mother
“As a professional kickboxer, Sarah helps me make weight for competitions and fights in a safe and effective way every time. She thinks flexibly, communicates openly, and is genuinely great to work with.”
Valence Bickel
Pro kickboxer and kyokushin karateka
“I really enjoy working with Sarah. She has a lot of knowledge and also personal experience with cutting weight for her own sport. Even when I share my doubts, she always gives a great explanation and everything always works out in the end!”
Tessa de Kom
Pro kickboxer
FAQ
Any questions?
Iron makes the haemoglobin that carries oxygen to your muscles, and powers cellular energy production. For active women, that means iron directly affects how hard you can train, how well you recover, and how your body adapts. When iron drops, performance follows — long before anything feels obviously wrong. The guide breaks down the science.
They might not have checked the full iron panel. Often only one marker is tested and comes back "normal" — but "normal" here refers to the general population, not active women. Download the guide for the full panel and the ranges that actually apply to you.
It usually shows up in your training first. Heavy legs, slower recovery, higher heart rate at the same pace, brain fog, exhaustion that rest doesn't fix — all signs to watch for. The guide has the full symptom checklist.
Most active women carry some level of risk, but it's much higher if you menstruate, follow a vegetarian or vegan diet, train 5+ hours per week, are postpartum or perimenopausal, or have a history of low iron. The guide details the red flags and when to act.
At least once a year if you train 5+ hours per week. More often if you have heavy periods, follow a vegetarian or vegan diet, are postpartum, recently donated blood, or have a history of low iron. Always ask for the full iron panel — not just a haemoglobin check.
No. This guide is educational information based on current sports nutrition and medical research. Always work with your GP or a sports dietitian for personalised advice and treatment.
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Want to go further?
Iron tested. What do I do next?
Getting a full iron panel is a great start — but actually increasing your iron levels without guidance is another thing. If you'd like support for a specific goal like weight loss or sports performance, I can help with that too.