Symptoms and signs:    In the first stages of iron deficiency, the athlete's performance begins to decline. The athlete may complain of burning thighs and nauseas from becoming anaerobic. Ice craving is also common. Athletes with mild iron-deficiency anemia may have a slight drop off in maximum performance. Determining serum ferritin is the most accurate test of one's iron levels. Two factors must be checked the sports doctor; the athlete's mean corpuscular volume (MCV), which is the average volume of individual cells in cubic micron, and the relative sizes of the erythrocytes.

Control and treatment:    The following are some ways to manage iron deficiency: ensure a proper balanced diet, including more red meat or dark poultry; avoid coffee and tea, as they effect iron absorption from grains; ingest Vitamin C sources, which enhance iron absorption; and take an iron supplement, consisting of ferrous sulfate 325 mg, check what the best amounts are for you with your doctor or pharmacist.

Footstrike Anemia, or hemolysis (destruction of red blood cells) :

Footstrike Anemia, or hemolysis (destruction of red blood cells), is secondary to iron deficiency in athletes. 

The cause of footstrike anemia, is as it name implies, is the impact of the foot as it strikes the floor surface. Impact forces serve to destroy normal erythrocytes within the vascular system.

Symptoms and signs:    hemolysis is characterized by mildly enlarged red cells, an increase in circulatory reticulocytes, and a decrease in the concentration of haptoglobin, which is a glycoprotein bound to haemoglobin and released into the plasma. Even if the athlete wears a well-designed and well-constructed shoe, this condition can occur. Footstrike anemia varies according to the amount of running performed. 

Control and treatment:    Footstrike anemia can be managed by running on soft surfaces wearing well-cushioned shoes and insoles, and running as lightly as possible on your feet.

Sickle Cell Anemia 

Sickle cell anemia is a chronic hemolytic anemia. CORRECTION "Approximately 35% of the black population in the USA has this condition" The overall incidence is eight out of 100,000 people. However, it is more common in some populations, affecting one out of 600 African Americans and one out of 1,000 to 1,400 Hispanic Americans. Because people with sickle trait were more likely to survive malaria outbreaks in Africa than those with normal hemoglobin, it is believed that genetically aberrant hemoglobin evolved as a protection against malaria. Although this disease is inherited and present at birth, symptoms usually don’t occur until after 4 months of age." source : http://www.nlm.nih.gov/medlineplus/ency/article/000527.htm

;8% to 13% are not anemic but carry this trait in their genes. If both parents carry the defective gene, the child will have sickle cell trait. The person with sickle cell anemia or trait can have siclemia. The person with the sickle cell trait may participate in sport and may never encounter problems until symptoms are brought on by some unusual circumstance.

In individuals with sickle cell anemia the red cells are sickle or crescent shaped. Within the red cells, an abnormal type of hemoglobin exists. It has been speculated that the sickling of the red blood cells results from an adaptation to malaria, which is prevalent in some parts of Africa.

The sickle cell has less potential for transporting oxygen and is fragile when compared with normal cells. A sickle cell's life span is 15 to 25 days, compared to 120 days of the normal red cell; due to this short life span severe anemia can occur in individuals with sickle cell anemia. Due to the distorted shape of the cell, the passage through the small blood vessels is inhibited and cause the clustering of cells and consequently the clogging of the blood vessels, producing thrombi (blood clots that block small blood vessels or a cavity of the heart), which hinders circulation. Death (worst case scenario of sickle cell sufferers), can occur for individuals with this condition from a stroke, heart disease, or an embolus (a mass of undissolved matter) in the lungs. Conversely, persons with sickle cell anemia may never have any problems relating to their condition. Four factors of exercise can cause sickling: acidosis; hyperthermia, dehydration of red blood cells, increasing hemoglobin concentration; and severe hypoxemia.

Symptoms and signs:    An athlete may never suffer any complications related to the sickle cell trait. However, a sickle cell crisis can be brought on by exposure to high altitudes or the overheating of the skin, as is the case with a high fever. Crisis symptoms include fever, severe fatigue, skin pallor, muscle weakness, and severe pain in the limbs and abdomen. Abdominal pain in the right upper quadrant may indicate a splenic syndrome syndrome in which there is an infarcation. This is especially characteristic of a crisis triggered by flying at high altitudes. Headache and convulsions may also be experienced.

The treatment of a sickle cell crisis is usually symptomatic. The physician may elect to give anticoagulants and analgesics for pain.