Ferritin is a marker we test to understand the stored levels of iron in your body. It is typically recommended to test ferritin levels to rule out any concerns of anemia or iron deficiency.
Changes to assessments
Last month, the Ontario Ministry of Health made changes to the reference ranges used by labs to assess iron levels. The lower limits previously varied between labs with reference ranges from 10 - 15 micrograms of ferritin per liter. The lower limits have now been changed to 30 micrograms per liter for adults and 20 micrograms per liter for children. This change makes a huge difference in detecting lower levels and treating low iron or anemia, especially for women who are more prone to low iron stores. It has always been an issue where women with a ferritin level of 11 for example, would be told that they are ‘fine’ because it was within normal range. When ferritin reference range is between 10-150 mg/l, having a level of 11 or even 15 is not fine for most. Many will experience symptoms of low iron with levels that low. This includes low energy, hair loss, anxiety, heavier menstrual bleeding, shortness of breath, headaches and more.
This change in reference range will now help diagnose low iron levels earlier and brings the bar to a much higher level when ruling out iron deficiency.
While low ferritin levels usually indicate iron deficiency, high levels may suggest iron overload or inflammation. I often use ferritin not only to investigate if there is iron deficiency but also to rule out inflammation. Especially in women who lose blood every month with their menstrual cycle, it is uncommon to see very high levels of stored iron. This can then indicate inflammation in the body. Whether you are dealing with infertility or other health challenges, it is important to treat inflammation in the body.
If iron stores are low and you are trying to conceive, it is important to make sure you are supplementing with iron. Low iron stores can affect your uterine lining, causing a thinner lining which can affect implantation. I have seen amazing changes in my patients who follow a vegetarian diet and have low iron stores when they start incorporating animal protein high in iron. While this may not resonate with all vegetarians, if you are having issues with your uterine lining and you are vegetarian, this may be the missing piece in achieving optimal lining thickness.
Supplementing with Iron
Supplementing with iron when deficient may be recommended. Many people do not like the idea of taking iron due to possible side effects of nausea and constipation. The good news is there are iron supplements you can take that are gentle on the digestive system and do not have any side effects.
Follow Up
Once on a supplement, it is important to follow-up with blood work to assess treatment efficacy and absorption. Some people can have a difficult time absorbing iron. This requires changing brands and or dosages to see improvements in iron stores.
It is important to note that for ideal absorption, iron supplements should always be taken away from other supplements and preferably away from coffee. Make sure to also use vitamin C to help with absorption.
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