Low serum ferritin (SF) is a sensitive and specific indicator of low total body iron stores.
The WHO defines low ferritin as levels <15 μg/L for adults and <12 μg/L for children. (1)However, in clinical practice, when ferritin levels dip below 30 μg/L, iron deficiency (ID) can be ascertained. (2)
Ferritin is an acute-phase reactant that is increased in serum during chronic inflammation. Cut-off values for ferritin in ID are increased to 100 μg/L in states of chronic inflammation. Transferrin saturation (TSAT) levels below 20% are also diagnostic of ID. In chronic inflammatory conditions when ferritin levels are 100–300 μg/L, TSAT should be used to diagnose iron deficiency. (3)
Note - serum iron levels fluctuate throughout the day and should not be used exclusively for a diagnosis of iron deficiency (4)
Reference
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