From the Guidelines
A ferritin level of 6 with normal iron levels is indicative of iron deficiency, and according to the most recent guidelines, iron supplementation is recommended to improve quality of life and prevent progression to iron deficiency anemia. In the context of a ferritin level of 6, which is below the threshold of 30 mg/L, indicating iron deficiency [ECCO Anemia Statement 1D], and with normal iron levels, the primary concern is the depletion of iron stores. The European Crohn's and Colitis Organization (ECCO) guidelines suggest that iron supplementation is essential in such cases [ECCO Anemia Statement 2A], 1.
Possible Explanations and Recommendations
- The low ferritin level suggests depleted iron stores, which could be due to various factors such as blood loss, poor dietary intake, or absorption issues [ECCO Anemia Statement 1D], 1.
- Normal serum iron levels indicate that the body is currently maintaining blood iron levels by drawing from the diminishing iron stores.
- Iron supplementation is crucial to replenish iron stores and prevent the progression to iron deficiency anemia, which can significantly impact quality of life [ECCO Anemia Statement 2A], 1.
- The choice between oral and intravenous iron supplementation depends on the severity of the condition, tolerance, and specific patient needs, with intravenous iron being more effective and better tolerated in certain cases [ECCO Anemia Statement 2A], 1.
- Dietary adjustments to include more iron-rich foods, such as red meat, spinach, beans, and fortified cereals, are also recommended to support iron replenishment.
- Regular follow-up with a healthcare provider is necessary to monitor ferritin levels and determine the underlying cause of the iron deficiency, addressing which is essential for long-term resolution [ECCO Anemia Statement 3E], 1.
From the Research
Possible Explanations for Low Ferritin Levels with Normal Iron Levels
- Low ferritin levels can indicate iron deficiency, even if iron levels are normal 2
- Iron deficiency can occur without anemia, and ferritin levels can be low even if hemoglobin levels are normal 2, 3
- Ferritin levels can be influenced by inflammation, and low ferritin levels can be seen in patients with chronic diseases 4
- Oral iron supplementation can increase ferritin levels, but the type of iron supplement used can affect the response 5, 6
- Ferrous bisglycinate supplementation has been shown to increase hemoglobin and ferritin concentrations in some populations, particularly pregnant women 6
Factors that Can Affect Ferritin Levels
- Iron intake and absorption 2, 3
- Inflammation and chronic diseases 4
- Type of iron supplement used 5, 6
- Population being studied (e.g. pregnant women, children) 6