From the Guidelines
For females of childbearing age, optimal ferritin levels should be maintained at greater than 15 ug/L to confirm iron deficiency is not present, as indicated by a study from the Centers for Disease Control and Prevention 1. When evaluating iron status in this demographic, it's crucial to consider serum ferritin concentration as an early indicator of iron stores.
- A serum ferritin concentration of less than or equal to 15 ug/L confirms iron deficiency, while a concentration greater than 15 ug/L suggests that iron deficiency is not the cause of anemia 1.
- The sensitivity and specificity of low serum ferritin concentration for iron deficiency are 75% and 98%, respectively, when the threshold is set at less than or equal to 15 ug/L 1. Key factors to consider in this age group include menstrual blood loss and increased iron demands during pregnancy, which can lead to iron deficiency.
- Regular screening and maintenance of adequate iron stores are vital for energy production, oxygen transport, and cognitive function.
- A diet rich in iron-containing foods, such as lean red meat, beans, and leafy greens, can help prevent iron deficiency, and supplementation with ferrous sulfate may be necessary in cases of detected iron deficiency 1.
From the Research
Optimal Iron, TIBC, and Ferritin Levels in Females of Childbearing Age
- The optimal iron, TIBC, and ferritin levels in females of childbearing age are not explicitly stated in the provided studies, but we can look at the general guidelines for iron deficiency diagnosis and treatment 2, 3.
- According to the study published in JAMA, iron deficiency is diagnosed by low serum ferritin (typically <30 ng/mL) in individuals without inflammatory conditions or by transferrin saturation (iron/total iron binding capacity × 100) less than 20% 2.
- The American Journal of Clinical Nutrition study suggests that a cutoff of 100 μg/L for serum ferritin concentration should be considered in most conditions, and 20% for TSAT, except in particular situations, including young healthy women with heavy menstrual flow 3.
- A study published in the Journal of the College of Physicians and Surgeons--Pakistan found that serum iron and TIBC give no additional information in the diagnosis of iron deficiency anemia and are redundant for the diagnosis of iron deficiency state if serum ferritin is available 4.
- In terms of treatment, oral iron supplements are typically first-line therapy, and intravenous iron is indicated for patients with oral iron intolerance, poor absorption, or certain chronic inflammatory conditions 2, 3.
- Vitamin C supplements are not essential to take along with oral iron supplements for patients with iron deficiency anemia, according to a randomized clinical trial published in JAMA Network Open 5.
Diagnosis and Treatment of Iron Deficiency
- Iron deficiency is a common condition that can cause symptoms such as fatigue, exercise intolerance, and difficulty concentrating 2.
- The diagnosis of iron deficiency is typically made by measuring serum ferritin levels, and treatment involves oral or intravenous iron supplements 2, 3.
- The treatment targets for iron deficiency include an increase in hemoglobin concentrations to 10-12 g/dL or normalization, and serum ferritin >100 μg/L or 200 μg/L 3.
Risk Factors for Iron Deficiency
- The most common causes of iron deficiency are bleeding (menstrual, gastrointestinal), impaired iron absorption (atrophic gastritis, celiac disease, bariatric surgical procedures), inadequate dietary iron intake, and pregnancy 2.
- Additional risk factors include use of nonsteroidal anti-inflammatory drugs, inflammatory bowel disease, and other chronic inflammatory conditions, such as chronic kidney disease, heart failure, and cancer 2.