What are the normal ferritin reference ranges for adult men, adult women, and children?

Normal Ferritin Reference Ranges

Normal ferritin values vary significantly by sex and age, with adult men typically ranging from 20-300 ng/mL, premenopausal women from 10-120 ng/mL, and postmenopausal women showing values similar to men.

Adult Men

• The median ferritin level in adult men reaches a plateau of approximately 120 ng/mL after age 32 years 1
• Population studies demonstrate ferritin values in males increase from a median of 23 μg/L at ages 12-16 years to stabilize in the 120s after age 32 1
• The lower limit of normal for most laboratories ranges between 15-30 ng/mL, though this may not reflect optimal iron stores 2
• One large population study reported mean ferritin of 108.0 ± 57.8 ng/ml in men 3

Adult Women (Premenopausal)

• Premenopausal women maintain significantly lower ferritin levels, with median values remaining in the 30s until menopause 1
• Average ferritin levels in adult women are approximately 43 ng/mL according to CDC guidelines 2
• Population studies show mean ferritin of 26.4 ± 22.7 ng/ml in premenopausal women 3
• The lower ferritin in young women is directly related to menstrual blood loss, which is the primary driver of iron deficiency in this population 2, 3

Adult Women (Postmenopausal)

• After menopause, ferritin levels in women rise substantially to approximately 80 μg/L, approaching male values 1
• Studies demonstrate an abrupt increase in ferritin after age 50 in women, with values no longer showing the low levels characteristic of reproductive years 3

Children and Adolescents

• In children and adolescents aged 12-16 years, median ferritin is approximately 23 μg/L 1
• Ferritin levels increase progressively with age through adolescence, particularly in males 1

Critical Clinical Thresholds

Iron Deficiency Diagnosis

• Ferritin <15 ng/mL has 100% specificity for absent bone marrow iron stores in women of childbearing age 2
• Ferritin <30 ng/mL generally reflects low body iron stores and has high specificity and sensitivity for diagnosing iron deficiency in adults 2, 4
• A ferritin level of 10 ng/mL definitively confirms depleted iron stores in adolescent females 2
• Iron deficiency is defined as serum ferritin ≤15 μg/L in some studies 5

Iron Overload Thresholds

• During therapeutic iron depletion for hemochromatosis, target ferritin is 50 μg/L for induction phase and 50-100 μg/L for maintenance 5
• Ferritin values >100 ng/mL may indicate iron overload, though this must be interpreted in clinical context 6

Important Caveats

Inflammation Confounding

• Ferritin is an acute-phase reactant, and infection, inflammation, or tissue damage can falsely elevate ferritin levels independent of true iron status 2, 6
• In inflammatory states, ferritin <45 ng/mL still suggests iron deficiency with 92% specificity 2
• Ferritin protein generated in response to inflammation contains much less iron than normal ferritin protein 6
• When inflammation is present, consider checking C-reactive protein to interpret ferritin accurately 2

Laboratory Reference Interval Limitations

• Current laboratory-reported lower limits of normal are often inappropriately low and contribute to structural underdiagnosis of iron deficiency 4
• Many studies establishing reference intervals did not exclude individuals at risk for iron deficiency and did not adhere to proper reference interval establishment standards 4
• The median lower limit of normal reported in literature is only 8 μg/L for females and 25 μg/L for males, which is below clinically meaningful thresholds 4

Optimal Treatment Targets

• For adolescent females with iron deficiency, treatment goals should achieve ferritin levels of at least 20-30 ng/mL as a minimum, with consideration of targeting 30-50 ng/mL for optimal iron stores 2