From the Guidelines
The recommended ferritin level for adults is between 50 and 150 ng/mL, with levels below 30 ng/mL indicating iron deficiency and levels below 15 ng/mL suggesting iron deficiency anemia requiring treatment. According to the most recent and highest quality study, 1, a ferritin cut-off value of 45 mg/dL is recommended for diagnosing iron deficiency in individuals with anemia, as it has an optimal balance of sensitivity and specificity. However, it is essential to consider that patients with inflammatory conditions may have iron deficiency or iron deficiency anemia despite a ferritin level greater than 45 mg/dL.
Key Considerations
- Ferritin levels between 20 and 250 ng/mL for men and 20 to 200 ng/mL for women are generally considered normal, though optimal levels are often between 50 and 150 ng/mL.
- Levels below 30 ng/mL indicate iron deficiency, while levels below 15 ng/mL suggest iron deficiency anemia requiring treatment.
- Certain populations, such as pregnant women, should maintain ferritin levels above 30 ng/mL, while patients with chronic kidney disease or heart failure may benefit from levels between 100-500 ng/mL.
- Excessively high ferritin levels (above 300 ng/mL for men or 200 ng/mL for women) can indicate inflammation, liver disease, or iron overload disorders and should be evaluated by a healthcare provider.
Treatment and Management
- For those with iron deficiency, supplementation with ferrous sulfate (325 mg, containing 65 mg elemental iron) taken 1-3 times daily between meals with vitamin C to enhance absorption is commonly recommended.
- Treatment typically continues for 3-6 months to replenish iron stores even after blood counts normalize.
- In some patients with severe iron deficiency or conditions in which oral iron may not be well absorbed, IV iron may be given initially, as discussed in 1.
From the Research
Recommended Ferritin Levels
There are no specific recommended ferritin levels mentioned in the provided studies. However, the studies discuss the importance of ferritin in iron deficiency anemia and its improvement with iron supplementation.
Iron Supplementation and Ferritin
- A study published in 1996 2 found that oral liquid ferrous gluconate increased ferritin levels by 7.8 micrograms/dl or 24% of the basal value in women with iron-deficiency anemia during or immediately after pregnancy.
- A 2022 study 3 compared the efficacy of ferric sodium EDTA in combination with vitamin C, folic acid, copper gluconate, zinc gluconate, and selenomethionine with oral ferrous sulfate and liposomal iron therapies in patients with chronic kidney disease and functional iron deficiency anemia. The study found significant improvements in iron profile parameters, including ferritin, in the group treated with ferric sodium EDTA in combination.
- A 2008 study 4 found that fortification of a complementary baby food with ferrous gluconate had a comparable efficacy to reduce iron deficiency in toddlers as ferrous sulfate.