Normal Iron Levels for a 7-Year-Old Male on a Complete Metabolic Panel (CMP)
A standard CMP does not include iron studies, so specific iron measurements would require additional testing beyond a basic CMP. For proper iron status assessment in a 7-year-old male, specific iron studies should be ordered separately.
Iron Status Parameters and Normal Values for Children
- Serum ferritin is the most specific test for iron deficiency in the absence of inflammation. For children, levels below 15 μg/L are highly specific for iron deficiency 1.
- Serum ferritin levels less than 30 μg/L generally indicate low body iron stores in children 1.
- For children aged 6-24 months, the average serum ferritin concentration is approximately 30 μg/L 1.
- Transferrin saturation, serum iron, and total iron-binding capacity are additional parameters that should be measured when assessing iron status 1.
Iron Deficiency Assessment in Children
- Iron deficiency represents a spectrum ranging from iron depletion (reduced stored iron) to iron-deficiency anemia (affecting organ system function) 1.
- In children, automated cell counters can detect changes in red cells that accompany iron deficiency, including:
- Reduced mean cell hemoglobin (MCH) - hypochromia
- Reduced mean cell volume (MCV) - microcytosis 1
- MCH is considered a more reliable marker of iron deficiency as it is less dependent on storage and counting machine used 1.
When to Screen for Iron Deficiency
- Children should be screened for iron deficiency at one year of age 2.
- For children at high risk of lead exposure, iron sufficiency should be assessed with complete blood count, ferritin, and C-reactive protein 1.
- Children with iron deficiency may show developmental delays and behavioral disturbances that can persist if not fully reversed 1.
Interpreting Iron Studies in Children
- A single hemoglobin or hematocrit measurement may be insufficient to detect iron deficiency, as these values decrease only when severe iron depletion is present 3.
- When evaluating iron status, a complete blood count should be accompanied by specific iron studies to avoid missing cases of iron depletion 3.
- Erythrocyte protoporphyrin concentration greater than 80 μg/dL of red blood cells in children aged 1-2 years indicates iron deficiency 1.
Important Considerations
- Inflammation can affect most indices of iron status, including serum iron and ferritin levels 1.
- Ferritin is an acute-phase protein, so apparently normal levels may occur with iron deficiency in the context of inflammation 1.
- Children aged 2-11 years have different iron requirements than infants or adolescents due to their growth patterns 1.
- Iron supplementation should be considered for children with confirmed iron deficiency to prevent developmental impacts 4.
Remember that iron studies are not typically included in a standard CMP and would need to be ordered separately for proper assessment of iron status in a 7-year-old child.