ITPP Use in Athletes: Clarification and Evidence-Based Context
The question appears to contain a critical misunderstanding: "ITPP" does not stand for "Intravenous Iron Therapy Protocol" in the context of athletic performance enhancement. The provided evidence exclusively addresses legitimate medical iron supplementation for iron deficiency, not performance-enhancing drug use.
What Athletes Actually Seek from Iron Supplementation
Athletes may use iron supplementation for two distinct reasons, which must be clearly differentiated:
Legitimate Medical Use (Evidence-Based)
Iron supplementation is medically appropriate only when iron deficiency is documented through laboratory testing (ferritin <35 μg/L or <100 ng/mL depending on guidelines). 1, 2
Female athletes face higher risk of iron deficiency due to menstrual blood loss and potentially lower dietary iron intake, with prevalence of 15-35% in female athletes versus 5-11% in male athletes 1
Iron deficiency impairs performance through reduced oxygen-carrying capacity and effects on hemoglobin, which has legitimate implications for aerobic performance 1
For documented deficiency in female athletes, the International Society of Sports Nutrition recommends 100 mg/day iron in divided doses for 8-12 weeks with vitamin C supplementation 2
Intravenous iron may be considered when oral iron is not tolerated, has failed, or when absorption is impaired, though this requires medical supervision 1, 2
Important Clinical Caveats
Iron supplementation without documented deficiency provides no performance benefit and is not recommended. 3 A 2008 review explicitly states that iron supplementation shows "no performance benefit" in athletes without deficiency 3.
Routine screening is recommended once yearly in male athletes and twice yearly in female athletes, with more frequent monitoring when deficiency has been previously detected 1
The distinction between treatment and abuse is critical: Legitimate iron replacement corrects a documented deficiency state, while inappropriate use in non-deficient athletes offers no benefit and carries potential risks including iron overload 1, 2.
Performance-Enhancing Drug Context
The broader evidence on performance-enhancing drugs in sport demonstrates that:
Most PEDs carry severe health risks without clear performance benefits, including anabolic steroids, growth hormone, and recombinant erythropoietin (rHuEPO) 4, 5
Only a few supplements have robust evidence for performance enhancement: caffeine, creatine, specific buffering agents, and nitrate 6, 7
The anti-doping challenge in elite sport reflects a "win at all costs" mentality that has arguably reached a tipping point damaging sport's reputation 5
If "ITPP" refers to a novel performance-enhancing compound not addressed in standard medical literature, athletes should be counseled that unapproved substances carry unknown health risks, potential anti-doping violations, and lack evidence of safety or efficacy. 6, 5