Are ferritin and transferrin levels of concern?

Assessment of Ferritin 183.6 and Transferrin 228.9 Levels

A ferritin level of 183.6 ng/mL and transferrin level of 228.9 mg/dL are within normal reference ranges and do not indicate a need for clinical concern. These values do not suggest either iron deficiency or iron overload requiring intervention.

Interpretation of Iron Status Markers

• Ferritin is the primary storage form of iron in the body and serves as an excellent indicator of total body iron stores 1.
• Normal ferritin ranges are typically:
  • Men: 20-300 ng/mL
  • Women: 20-200 ng/mL 1, 2
• Your ferritin level of 183.6 ng/mL falls within these normal parameters.
• Transferrin is the main iron transport protein in blood, with normal ranges typically between 200-360 mg/dL 1.
• Your transferrin level of 228.9 mg/dL is within normal limits.

Clinical Significance

When to Be Concerned About Ferritin Levels

• Ferritin levels <20 ng/mL are highly specific for iron deficiency anemia 3, 4.
• Ferritin levels >1000 ng/mL in combination with elevated liver enzymes would warrant investigation for potential hemochromatosis or iron overload 1.
• Serum ferritin between 20-100 ng/mL represents an optimal range associated with the lowest cardiovascular and metabolic risk 5, 6.
• Your ferritin level of 183.6 ng/mL, while slightly above this optimal range, does not indicate iron overload requiring intervention.

Transferrin Saturation - The Missing Piece

• While your transferrin level is provided, the transferrin saturation percentage (TS%) would provide more complete information about iron status 1.
• TS% is calculated using serum iron and transferrin levels and helps distinguish between different causes of abnormal ferritin 1.
• Normal TS% ranges from 20-50% 1.
• TS% >45% with elevated ferritin would raise concern for potential hemochromatosis 1.
• Without the TS% value, we can still conclude your transferrin level itself is normal.

Clinical Algorithm for Interpreting Iron Studies

1. Normal iron status: Ferritin 20-300 ng/mL (men) or 20-200 ng/mL (women), transferrin 200-360 mg/dL, and TS% 20-50% → No intervention needed 1

2. Iron deficiency:

   • Ferritin <20 ng/mL → Definite iron deficiency 3, 4
   • Ferritin 20-100 ng/mL with TS% <20% → Possible iron deficiency 1

3. Iron overload concern:

   • Ferritin >300 ng/mL (men) or >200 ng/mL (women) with TS% >45% → Consider hemochromatosis evaluation 1
   • Ferritin >1000 ng/mL with abnormal liver enzymes → High risk for cirrhosis, requires immediate evaluation 1

Conclusion for Your Values

• Your ferritin (183.6 ng/mL) and transferrin (228.9 mg/dL) values fall within normal reference ranges 1, 2.
• These values do not suggest either iron deficiency or significant iron overload 1.
• No specific intervention is indicated based on these values alone 1.