Iron injections are primarily used to treat serious anemia arising from iron deficiency, but according to experts they also improve endurance. As a result their use has spread across the country over the last 20 years, primarily among female athletes who are more prone to anemia.
Following a 2015 case in which an athlete was confirmed to have suffered liver damage as a result of excess iron levels, in April, 2016 the JAAF issued a warning for coaches to stop the practice of injections, saying, "The accumulation of iron in the internal organs has deleterious effects on the body." In an interview two women who graduated prior to the JAAF's warning talked about their firsthand experience in high school. Under their coaches' direction both used iron injections throughout their high school careers and produced strong results, but after graduating they never improved and came to regret their past histories of injection.
"Coach would say, 'OK, time to go do it,' and then they'd inject me," one woman who graduated from a high school in East Japan and continued to compete in university said of her high school days. Her coach would take her to a local hospital up to three times a month, and a week before a big race all five members of the ekiden team would receive injections. The coach would tell them, "It has vitamins mixed in so it's fine."
A doctor who worked on the athlete confirmed, "All five girls received iron injections and iron medicine drips." The doctor said that the coach brought girls from the team to the hospital every week beginning around September, and that they would often receive injections without having any blood testing done beforehand.
At the National High School Ekiden both the athlete and her team finished high up in the field. If she had kept developing at that rate she could have become one of the country's top runners. When she had blood work done for her university team she was the only one whose results indicated a massive overload of iron. The concentration per ml of serum ferritin, a protein which serves as an indicator of the body's iron storage level, far exceeded the normal range of 25 to 250 nanograms. Her university coach was surprised, saying, "You've been putting something in your body, haven't you?"
Ever since high school the woman hasn't felt right. She developed problems with reduced functioning of her internal organs, thought to be an effect of iron overdose, and there were times when even just jogging was hard. "In high school I was ignorant," she said. "Your times might improve by taking injections, but I'd never want to go back to those days again."
Some top high schools have continued the practice of iron injections for team members even after the JAAF's 2016 warning. Although the schools publicly state that they have abandoned the technique, some staff members have admitted it in private interviews, and the JAAF believes that other schools may likewise be continuing to employ the injections.
A JAAF spokesperson commented, "The environment surrounding our athletes is in a crisis situation. We want to work hard to fully understand the extent of the use of iron injections and will take appropriate measures promptly." The JAAF will issue another warning at the Dec. 23 National High School Ekiden Championships and is considering mandatory submission of blood test results at next year's edition.
translated and edited by Brett Larner