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Iron stores - understand ferritin levels & recognise deficiency

Iron stores are measured by the ferritin value. Find out what low or high values mean, what the possible causes are and how the stores can be replenished in a targeted manner.

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Things worth knowing about "Iron stores"

The body's iron stores are crucial for a stable supply of the vital trace element iron, which is primarily required for oxygen transport in the blood, cellular respiration and energy production.

Most of the iron in the body is bound to haemoglobin, while some is stored in cells and tissues in the form of ferritin - particularly in the liver, spleen and bone marrow. Ferritin is therefore the most meaningful laboratory value for assessing the level of iron stores.

A ferritin value below 30 ng/ml is usually an indication of empty or severely reduced iron stores, even if the haemoglobin value is still within the normal range. In women, values below 15 ng/ml, in men below 30 ng/ml are clinically conspicuous. The most common causes include blood loss (e.g. menstruation, internal bleeding), chronic inflammatory diseases, gastrointestinal diseases or a diet low in iron. Athletes, pregnant women, breastfeeding mothers and vegetarians are also more frequently affected. A ferritin value of over 300 ng/ml can indicate an iron overload or inflammatory processes in the body - therefore the sole interpretation of ferritin without other values (e.g. CRP, transferrins) is not recommended. Therefore, the sole interpretation of ferritin without other values (e.g. CRP, transferrin saturation) is not always meaningful. 

If a deficiency is proven, iron supplements (oral or intravenous) can replenish the stores in a targeted manner. An improvement usually occurs after several weeks. Important: Therapy should not be administered on suspicion, but only after blood count checks

Important facts about iron stores (ferritin): 

  • Ferritin is the central marker for assessing iron stores 
  • Low values indicate iron deficiency, high indicate inflammation or inflammation.inflammation or overload 
  • causes of empty memory: blood loss, intestinal problems, malnutrition 
  • Ferritin < 30 ng/ml clinically conspicuous in case of complaints 
  • Iron substitution only after medical clarification and control 

Literature

  • World Health Organisation (WHO). (2020). "Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations." 
  • Camaschella, C. (2019). "Iron deficiency." 
  • Blood. Thomas, D. W. et al (2013). "Diagnosis and management of iron deficiency anaemia: a clinical update." BMJ.

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