Status of medication in sport
Iron supplementation is not prohibited by WADA.
But, if iron is given by an intravenous infusion of greater than 100mls, that volume of intravenous fluid is a prohibited method by WADA (>100ml in 12 hours unless performed in a hospital setting). Iron intravenous (IV) infusions may be indicated for athletes in the following situations:
- Iron deficiency anaemia (Low haemoglobin in association with low ferritin)
- Iron deficiency without anaemia (Normal haemoglobin with ferritin 100mls, this is a prohibited method of administration by WADA) so a TUE is required unless the infusion is delivered in a hospital setting.)
Therefore if an iron infusion with a volume of fluid >100ml is contemplated for an athlete (and the athlete requires a TUE), the doctor should either…
1. Consider using a permitted method of administration for the Iron (oral or Ferrinject) or
2. Apply for a therapeutic use exemption (TUE) for the fluid infusion required to deliver the iron. Clinical justification for the infusion will be required (see below).
What information is required for a TUE application?
- A completed TUE application form signed by the treating doctor and athlete
- A (typed) clinical letter from the treating doctor that includes:
- current diagnosis and a summary of clinical history of iron deficiency
- reason for use of IV infusion to deliver the iron, rather than oral iron (or smaller volume bolus infusion)
- A description of the fluid (type and volume) that will be infused
- the date of infusion
- Place where infusion will be performed (e.g. Drs rooms)
- any other additional relevant clinical information from the treating physicia
- Copy of original pathology reports of iron levels (Iron Studies) and Full Blood Examination (FBE)
For additional information please refer to the medical information relating to your condition on the WADA website.