From the Guidelines
Increasing ferritin levels can be achieved through oral iron supplementation, dietary changes, and intravenous iron therapy.
Methods to Increase Ferritin Levels
- Oral Iron Supplementation: Oral iron supplementation is the first line of treatment for increasing ferritin levels, with a typical regimen of approximately 100 mg day−1 iron in divided doses for 8–12 weeks, supplemented with iron pro-absorptives such as vitamin C 1.
- Dietary Changes: Increasing dietary intake of iron is the initial step in treating iron deficiency, with a recommended daily intake of at least 22 mg day−1 iron for highly active individuals, such as female athletes 1.
- Intravenous Iron Therapy: Intravenous iron should be used if the patient does not tolerate oral iron, ferritin levels do not improve with a trial of oral iron, or the patient has a condition in which oral iron is not likely to be absorbed 1.
Key Considerations
- Treatment Evaluation: Treatment of iron deficiency requires evaluation by a physician and sports dietitian to elucidate the cause of the deficiency and rule out any underlying pathophysiology 1.
- Supplementation Regimen: Slow-release ferrous sulfate formulations are recommended as the most effective and tolerable supplement 1.
- Parenteral Replenishment: Intravenous iron supplementation is preferred to intramuscular injection for parenteral replenishment, and is reserved for special cases, such as severe deficiency or enteral absorption disruption 1.
From the Research
Methods to Increase Ferritin Levels
To increase ferritin levels, the following methods can be considered:
- Iron supplementation: Iron supplements can be taken orally or through intramuscular injections. A study 2 found that iron injections are significantly more effective in improving ferritin levels over 30 days than oral tablets.
- Dietary changes: Consuming iron-rich foods can help increase ferritin levels. However, there is no direct evidence from the provided studies to support this claim.
Factors Affecting Ferritin Levels
Several factors can affect ferritin levels, including:
- Inflammation: Serum ferritin may increase in response to inflammatory processes, regardless of iron stores 3.
- Obesity: Ferritin levels may be higher in obese patients, particularly those with type 2 diabetes and hypertension 4.
- Iron mobilization and deposition: The turnover of ferritin iron is preferential to that of hemosiderin iron, and the initially existed ferritin iron is gradually replaced by the ferritin iron recovered by taking iron from hemosiderin in iron mobilization 5, 6.
Diagnosis of Iron Deficiency
Diagnosing iron deficiency can be challenging, particularly in elderly subjects or those with chronic medical conditions. A study 3 found that the conventional cutoff of serum ferritin for the diagnosis of iron deficiency anemia in young adults is not appropriate for the elderly population. Another study 4 suggested that ferritin may not be a reliable index for evaluating iron stores in obese patients, particularly when associated with comorbidities such as type 2 diabetes and hypertension.