Is a ferritin serum level of 169 considered abnormal?

Interpretation of a Ferritin Level of 169

A ferritin level of 169 μg/L is within normal range and not considered abnormal for most adults. 1

Normal Ferritin Reference Ranges

• Average ferritin levels in the US population are approximately 135 μg/L for men and 43 μg/L for women 1
• For men, the 95% confidence range is 21-447 μg/L 2
• For non-menstruating women, the 95% confidence range is 26-279 μg/L 2
• A level of 169 μg/L falls well within these normal ranges 1, 2

Clinical Significance of a Ferritin Level of 169

• This level does not suggest iron deficiency, which is typically defined as ferritin ≤15-20 μg/L 1, 3
• This level is also not high enough to suggest significant iron overload, which is typically associated with levels >300 μg/L in men or >200 μg/L in women 4
• A ferritin of 169 represents adequate iron stores for most adults 1

Factors That May Influence Ferritin Levels

• Ferritin is an acute phase reactant that can be elevated in inflammatory conditions independent of iron status 4, 5
• Body mass index (BMI) ≥25 kg/m² is associated with higher ferritin levels in men ≥35 years old and in postmenopausal women 6
• Liver function affects ferritin levels, with serum γ-glutamyltransferase (GGT) correlating with serum ferritin 6
• Ferritin levels have been increasing in the general population over time (21% higher in men and 10% higher in women in 2005 compared to 1995) 6

When Further Evaluation May Be Warranted

• If clinical symptoms suggest iron deficiency despite normal ferritin (e.g., in inflammatory conditions), additional testing such as transferrin saturation may be helpful 4
• If there are signs of liver disease, elevated ferritin may reflect inflammation rather than iron overload 4, 7
• If there is a family history of hemochromatosis, genetic testing may be considered even with ferritin levels in the normal range 4

Monitoring Recommendations

• With a normal ferritin level of 169, routine monitoring is not necessary unless there are specific clinical indications 4
• If monitoring is clinically indicated, serum ferritin should be checked approximately every 6 months 4
• Unexpected changes in serum ferritin levels should be investigated, as significant fluctuations are not a normal feature 4

In conclusion, a ferritin level of 169 μg/L is within normal physiological range and generally does not require further investigation or treatment in the absence of specific symptoms or risk factors for iron-related disorders.