What is the optimal range for serum ferritin levels?

From the Guidelines

The optimal range for ferritin levels is between 50-100 lg/L, as it is the target range for depletion of iron stores and reflects a balance between iron deficiency and overload. This range is based on the most recent and highest quality study by the American Association for the Study of Liver Diseases 1. Maintaining ferritin levels within this range is crucial for preventing iron overload conditions like hemochromatosis, which can lead to organ damage and other complications.

Key Considerations

• Ferritin levels below 50 lg/L may indicate iron deficiency, while levels above 100 lg/L may suggest iron overload 1.
• Therapeutic phlebotomy is the mainstay of treatment for hemochromatosis, and the goal is to reduce iron stores to normal levels, which can be achieved by maintaining ferritin levels between 50-100 lg/L 1.
• Regular monitoring of ferritin levels is essential for individuals with known iron metabolism disorders, and treatment should be tailored to the specific condition, whether it be iron supplements for deficiency or therapeutic phlebotomy for overload 1.
• Diet modifications can help maintain healthy ferritin levels, with iron-rich foods like red meat, beans, and leafy greens beneficial for those with low ferritin, while those with high levels should limit iron-rich foods and vitamin C, which enhances iron absorption 1.

Clinical Implications

• The optimal range for ferritin levels may vary by individual, and healthcare providers should consider factors such as age, sex, and medical history when interpreting ferritin levels 1.
• The endpoint of therapeutic phlebotomy is not well established, but achieving a target serum ferritin level of less than 50 lg/L is a common practice 1.
• However, the American Association for the Study of Liver Diseases recommends a target range of 50-100 lg/L, which is a more balanced approach to managing iron stores 1.

From the Research

Optimal Range for Ferritin Levels

The optimal range for ferritin levels is a topic of interest in the medical field, with various studies providing insights into its significance.

• Ferritin levels are used as an indicator of iron stores in the body, with low levels indicating iron deficiency and high levels potentially indicating iron overload 2, 3, 4, 5, 6.
• According to a study published in the Journal of Clinical Medicine, hyperferritinemia is a non-specific finding that can be caused by various factors, including acute phase reactions and underlying conditions 4.
• A study published in Metallomics suggests that optimal ferritin levels for cardiovascular mortality reduction may range from 20 to 100 ng/mL, with transferrin saturation levels between 20% and 50% 6.
• The American Society of Hematology notes that serum ferritin levels can be used to estimate tissue iron, and that chelation therapy may be necessary for patients with iron overload 5.
• The Cochrane database of systematic reviews notes that ferritin concentration is a reasonably sensitive and specific test for iron deficiency in people presenting for medical care, but its performance in asymptomatic individuals is less clear 3.
• A study published in JAMA notes that iron deficiency is a common condition that can cause symptoms such as fatigue, exercise intolerance, and difficulty concentrating, and that ferritin levels are an important diagnostic tool 2.

Key Findings

• Low ferritin levels (<30 ng/mL) are highly specific for iron deficiency 2, 3.
• Elevated ferritin levels can indicate iron overload, but can also be caused by other factors such as inflammation and acute phase reactions 3, 4.
• Optimal ferritin levels may range from 20 to 100 ng/mL for cardiovascular mortality reduction 6.
• Ferritin levels above 194 ng/mL may be associated with all-cause mortality in population cohorts 6.

Ferritin Levels and Health Outcomes

• Elevated ferritin levels have been associated with increased mortality and disease severity in various conditions, including peripheral arterial disease and SARS-CoV-2 infection 6.
• Low ferritin levels can cause symptoms such as fatigue, exercise intolerance, and difficulty concentrating, and can be treated with oral iron supplementation or intravenous iron therapy 2.