Skip to main content

Iron Injections Remain an Issue in Japanese High School Girls' Distance Running

To treat anemia some of the country's top high school ekiden teams inappropriately utilize iron injections that could have a harmful effect on athletes' health.

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.

source articles:
translated and edited by Brett Larner

Buy Me A Coffee


CK said…
" considering mandatory submissions of blood test results..."
Wow! Has this ever happened before at high school level in any country in any sport?
In fact this article prompted me to re-read your 19 April 2016 linked article and ponder your footnote with a little more gravity. Hmmm...
Once again, thanks for all the translation.
TokyoRacer said…
What the hell is wrong with Japanese parents? Like the athletes, they think the coaches are gods. Hello - they're just high school coaches! Don't be so irresponsible!
Anonymous said…
Overdose of iron does not improve normal human performance. It only ends anemia.
These girls were anemic. The performance seemed to be improved because you became normal.
That is why iron is not doping.
The crisis is not iron injection. They should ban is hard exercises and hard diet. If they will use the doping test approach, it will increases anemia.
I hope children read the news and children will not overdose iron for performance improvement. It does not improve performance. It is not good for your life.
yuza said…

I am curious to know what you put the liver damage down to? Over training? Drinking alcohol?

I do agree that diet and training needs to be balanced for young athletes - particularly young female athletes - in order for them to be healthy and perform at their best.

But giving an athlete three iron injections a month which results in said athlete's iron levels being abnormally high is just wrong and dangerous.

Most-Read This Week

One Month Until the Japanese Olympic Marathon Trials

It's one month to go until what's bound to be the best marathon of 2019, Japan's 2020 Tokyo Olympics marathon trials, the Sept. 15 Marathon Grand Championship Race. Up to now Japan has typically picked its Olympic and World Championships marathon teams based on performances in a series of specific races, primarily the Fukuoka International Marathon, Tokyo Marathon and Lake Biwa Marathon for men, and the Saitama International Marathon, Osaka International Women's Marathon and Nagoya Women's Marathon for women. This time around they're going with a U.S.-style one-shot trials race, the MGC Race.

People had a nearly two-year window from August, 2017 to April this year to hit tough standards to qualify. Only 34 men and 15 women made it, and after withdrawals for the Doha World Championships the MGC Race's final entry list is just 31 men and 12 women. Swedish Athletics Federation official Lorenzo Nesicalled it "the most difficult marathon race ever to quali…

MGC Race Olympic Marathon Trials Qualifier - Naoki Okamoto

Naoki Okamotoage: 35
sponsor: Chugoku Denryoku
graduated from: Tottori Chuo Ikuei H.S., Meiji University

best time inside MGC window:
2:11:29, 1st, 2018 Hokkaido Marathon

PB: 2:11:29, 1st, 2018 Hokkaido Marathon

other PBs:
5000 m: 13:37.71 (2009) 10000 m: 28:05.84 (2011) half marathon: 1:02:16 (2009)

marathons inside MGC window (Aug. 1 2017 – April 30 2019)
DNF, 2019 Beppu-Oita Marathon
1st, 2018 Hokkaido Marathon, 2:11:29 – PB
DNF, 2018 Boston Marathon

other major results:
4th, 2019 Shibetsu Half Marathon, 1:03:53
2nd, 2019 New Year Ekiden Fourth Stage (22.4 km), 1:05:13
1st, 2018 Chugoku Corporate Ekiden Sixth Stage (19.0 km), 56:25 – CR
1st, 2018 Ome 30 km Road Race, 1:33:09
21st, 2017 Tokyo Marathon, 2:13:53

We’re picking Okamoto as our official dark horse of the men’s race. The second-oldest man in a field, Okamoto is a journeyman corporate leaguer who never broke 2:12 and whose PBs all came a decade ago. But, nearing the end of his career, over the last two years he has really come on…

Running the 2020 Tokyo Olympics Marathon Course Part Three - Men's Marathon and Overall Summary

Today marks one year until the men's marathon at the 2020 Tokyo Olympics. For the third time in the last week, once last Friday with one year to go to the Olympic women's marathon, once on Monday with a likely competitor in the men's marathon, and again today, I ran most of the Olympic marathon course taking temperature and humidity readings every half an hour to get a handle on what kind of conditions athletes in each race can expect to be facing. Between the three runs I covered about 80 km, and including the two times I did it last summer two years out from the women's marathon and men's marathon about 135 km, on the Olympic course. To get it out of the way off the bat, a couple of days ago a few readers told me that the Buy Me A Coffee button wasn't working. I think the problem has been fixed, so if you're so inclined please feel free to use it. Your support for JRN is always really appreciated.

And now on to the run.

This time out I went to the start …