Hepcidin and interleukin-6 responses to endurance exercise over the menstrual cycle

Eur J Sport Sci. 2022 Feb;22(2):218-226. doi: 10.1080/17461391.2020.1853816. Epub 2020 Dec 17.

Abstract

The aim of the current study was to investigate iron metabolism in endurance trained women through the interleukin-6, hepcidin and iron responses to exercise along different endogenous hormonal states. Fifteen women performed 40 min treadmill running trials at 75% vVO2peak during three specific phases of the menstrual cycle: early follicular phase (day 3 ± 0.85), mid-follicular phase (day 8 ± 1.09) and luteal phase (day 21 ± 1.87). Venous blood samples were taken pre-, 0 h post- and 3 h post-exercise. Interleukin-6 reported a significant interaction for menstrual cycle phase and time (p=0.014), showing higher interleukin-6 levels at 3 h post-exercise during luteal phase compared to the early follicular phase (p=0.004) and the mid-follicular phase (p=0.002). Iron levels were significantly lower (p=0.009) during the early follicular phase compared to the mid-follicular phase. However, hepcidin levels were not different across menstrual cycle phases (p>0.05). The time-course for hepcidin and interleukin-6 responses to exercise was different from the literature, since hepcidin peak levels occurred at 0 h post-exercise, whereas the highest interleukin-6 levels occurred at 3 h post-exercise. We concluded that menstrual cycle phases may alter interleukin-6 production causing a higher inflammation when progesterone levels are elevated (days 19-21). Moreover, during the early follicular phase a significant reduction of iron levels is observed potentially due to a loss of haemoglobin through menses. According to our results, high intensity exercises should be carefully monitored in these phases in order not to further compromise iron stores.

Keywords: Oestrogen; anaemia; exercise; female athletes; progesterone.

MeSH terms

  • Exercise / physiology
  • Female
  • Follicular Phase
  • Hepcidins*
  • Humans
  • Interleukin-6*
  • Luteal Phase
  • Menstrual Cycle / physiology
  • Progesterone

Substances

  • Hepcidins
  • Interleukin-6
  • Progesterone