NEW THRESHOLDS FOR THE USE OF FERRITIN CONCENTRATIONS TO ASSESS IRON STATUS IN INDIVIDUALS AND POPULATIONS - WHO ferritin guideline brochure

Q: Why is assessing iron status important in individuals and populations?

Iron deficiency can lead to anaemia, fatigue, reduced child development, and decreased physical performance, while iron overload can cause major organ and hormonal diseases. Early detection supports timely treatment and helps guide appropriate clinical and public health solutions.

Q: What test is commonly used to measure iron status, and how is ferritin used?

Serum or plasma ferritin is widely used to measure iron status. Ferritin measurement helps identify iron deficiency and supports work-up for iron overload, using age-specific thresholds.

Q: How do the WHO ferritin cut-off thresholds differ by age group and health status?

The guideline provides recommended cut-off values by age group, separating apparently healthy individuals from those with infection or inflammation for iron deficiency, and separating apparently healthy individuals from non-healthy individuals for overload risk. The table lists distinct ferritin thresholds across infants, children, adolescents, adults, older persons, and pregnant women.

Oct 12, 2026

Uploaded by 4398046744996

Ferritin-guideline material explains why accurate assessment of iron deficiency and iron overload is essential for diagnosing clinical conditions and informing public health actions. It describes serum or plasma ferritin as a common test and introduces updated WHO ferritin cut-off thresholds by age group, distinguishing apparently healthy individuals from those with infection or inflammation. It also summarizes how ferritin measurement supports population monitoring, intervention selection, and evaluation of program impact, helping reduce anemia risk and identify overload risk.

LanguageEnglish

CategoryGeneral

FormatPDF

Pages2

Reading Time1 min

AccessFree to download

Overview of iron deficiency and iron overload

Ferritin as a key test for iron status

WHO updated ferritin thresholds

Cut-off values by age group (Table 1)

Interpretation notes for inflammation and pregnancy

Public health and clinical use

NEW THRESHOLDS FOR THE USE OF FERRITIN CONCENTRATIONS TO ASSESS IRON STATUS IN INDIVIDUALS AND POPULATIONS Iron deficiency and iron overload are common clinical and public health problems. Iron deficiency can result in anaemia, fatigue, lethargy, reduced child development and physical exercise performance, and may suggest serious underlying disease. Iron overload disorders can be either primary or classic haemochromatosis or secondary haemochromatosisand can result in liver, heart and hormonal diseases such as diabetes. In both cases, appropriate detection is essential to help guide clinical and public health solutions. Early diagnosis is required to initiate prompt treatment and to avoid further iron accumulation in the body. An important and commonly used test for iron status measurement is serum or plasma ferritin. Measurement offerritin is available in many laboratories and is a standard measure for iron deficiency and as part of the work-up for iron overload. Specific thresholds for ferritin are used to detect iron deficiency and overload in different age groups. The World Health Organization (WHO) estimates that 42% of children less than 5 years of age and 40% of pregnant women worldwide are anaemic. Iron deficiency, haemoglobinopathies and malaria are considered as the three top causes of anaemia globally. WHO has updated the specific ferritin thresholds used to diagnose iron deficiency and overload, in individuals with and without underlying medical conditions, using its rigorous methods for evidence-informed guideline development. The new WHO Guideline: Use of ferritin concentrations to assess iron status in individuals and populations updates the recommended cut-off values to define iron deficiency and risk of iron overload in apparently healthy and non-healthy individuals by age group (Table 1). Table 1. Recommended cut-off values to define iron deficiency and risk of iron overload in apparently healthy and non-healthy individuals by age group | | SERUM FERRITIN (Μg/L)a,b | | | | | --- | --- | --- | --- | --- | | | IRON DEFICIENCY | | RISK OF IRON OVERLOAD | | | | Apparently healthy individualsc | Individuals with
infection or
inflammation | Apparently healthy individuals | Non-healthy
individuals | | Infants
(0–23 months) | <12 | <30 | — | — | | Preschool children
(24–59 months) | <12 | <30 | — | — | | School-age children (5–12 years) | <15 | <70 | >150 females
>200 males | >500d | | Adolescents (13–19 years) | <15 | <70 | >150 females
>200 males | >500 | | Adults
(20–59 years) | <15 | <70 | >150 females
>200 males | >500 | | Older persons
(60+ years) | <15 | <70 | >150 females
>200 males | >500 | | Pregnant women | <15 (first trimester)e | — | — | — | a From previous WHO recommendations and new evidence. b Markers of inflammation should be assessed along with the ferritin concentration, and ferritin adjusted as necessary. c For the purposes of this guideline, an apparently healthy individual is defined as an individual with physical well-being for their age and physiological status, without detectable diseases or infirmities. d In adult, non-healthy populations, a ferritin concentration exceeding 500 µg/L may indicate risk of iron overload or other disease. This cut-off value indicates the need for further clinical and laboratory evaluation to establish the diagnosis and underlying cause of the ferritin levels. e There are several physiological changes occurring in pregnancy that may contribute to the variation in thresholds of iron deficiency in pregnancy as defined by serum ferritin, including a physiological rise in acute phase proteins secondary to pregnancy; second trimester plasma volume expansion; and changes in inflammatory measures in the third trimester of pregnancy. Accurate determination of iron status is crucial for diagnostic and screening purposes in the clinical setting and for guiding public health interventions. The measurement

FAQs

Why is assessing iron status important in individuals and populations?

Iron deficiency can lead to anaemia, fatigue, reduced child development, and decreased physical performance, while iron overload can cause major organ and hormonal diseases. Early detection supports timely treatment and helps guide appropriate clinical and public health solutions.

What test is commonly used to measure iron status, and how is ferritin used?

Serum or plasma ferritin is widely used to measure iron status. Ferritin measurement helps identify iron deficiency and supports work-up for iron overload, using age-specific thresholds.

How do the WHO ferritin cut-off thresholds differ by age group and health status?

The guideline provides recommended cut-off values by age group, separating apparently healthy individuals from those with infection or inflammation for iron deficiency, and separating apparently healthy individuals from non-healthy individuals for overload risk. The table lists distinct ferritin thresholds across infants, children, adolescents, adults, older persons, and pregnant women.

Oct 12, 2026

Uploaded by 4398046744996