Treatment of Serum Ferritin Deficiency Regardless Haemoglobin Level

The concentration of serum ferritin is positively correlated with the size of the total body iron stores in the absence of inflammation. [1] It is mainly concentrated in the liver, spleen and bone marrow in humans. The serum ferritin is present in all cells of the body. [ 2] Normal values are generally 12 – 300 ng/mL for men and 12 – 150 ng/mL for women. Some patients have clinical symptoms of iron deficiency anaemia as fatigue, general weakness, hair loss, depressed mode although their haemoglobin and serum ferritin are in the lower normal values [3].

Patients sample are 1- females 2- aged from 15–70 years 3-who have problems with oral iron either not getting benefit from it or can't tolerated it or not compliant with oral iron treatment. On presentation patients subjected for the following tests and then repeated after one month of intravenous iron infusion 1- complete blood count, 2- serum ferritin, 3- serum vitamin B12 and folate, 4- HPLC, 5-G6PD, 6- Coagulation profile (INR, APTT), 7 – LFT and RFT.

Group 1: responded laboratory and clinically to treatment.

Group 2: responded laboratory and clinically to treatment.

Group 3: responded laboratory and clinically to treatment.

Three group of patients noticed:

Group 1 Low Hb and low s. ferritin where symptoms of iron deficiency are exist in this group of patients.

Group 2 Hb is normal and s. ferretin where symptoms of iron deficiency are exist in this group of patients.

Group 3 both Hb and s. ferretin where symptoms of iron deficiency are exist in this group of patients.

Group 4 control group was just observed and reassured.

Iron is essential element in all cells of human [4], so when it is low it means dysfunctions in other cells and organs like hair, muscles and brain.

Lower normal level of Serum Ferritin is enough for normal Hb level but it is may be not enough for normal functions in other organs where the iron is needed. So that why it might be need to treat S. ferritin deficiency and shouldn't wait to reach to the level of IDA. According to that it might be indicated to: 1- Treat patients when s. ferritin is low even if Hb is normal. 2 - Lower normal value has to be increased to at least to 50mg to ensure that not only Hb will become normal but also other organ function.

Putting in mind that the range of Hb could reach to 305ng/ml without reaching to the toxic level of iron overload.

1. Serum Ferritin concentrations for the assessment of iron status and iron deficiency in populations, WHO/NMH/NHD/MNM 11. 2

2. Ahmet E. ERBAYCU, Hayriye UÇAR, Mehmet GÜLPEK, The Contribution of Serum Ferritin, Iron, Iron Binding Capacity and Bronchoalveolar Lavage Ferritin Levels in Differential Diagnosis of Lung Cancer from Benign Pulmonary Diseases, UHOD Say○/Number: 3 Cilt/Volume: 17 Y○l/Year: 2007

3. Iron Deficiency Anemia, Source Medical Disadbility Advisor

4. Human homeostasis, Source:

1. Serum Ferritin concentrations for the assessment of iron status and iron deficiency in populations, WHO/NMH/NHD/MNM 11. 2

2. Ahmet E. ERBAYCU, Hayriye UÇAR, Mehmet GÜLPEK, The Contribution of Serum Ferritin, Iron, Iron Binding Capacity and Bronchoalveolar Lavage Ferritin Levels in Differential Diagnosis of Lung Cancer from Benign Pulmonary Diseases, UHOD Say○/Number: 3 Cilt/Volume: 17 Y○l/Year: 2007

3. Iron Deficiency Anemia, Source Medical Disadbility Advisor

4. Human homeostasis, Source:

1. Serum Ferritin concentrations for the assessment of iron status and iron deficiency in populations, WHO/NMH/NHD/MNM 11.2

Is to assess the benefit of raise up Serum Ferritin level to a new higher reference lower value as 50 ng/mL instead of the present lower values, because the present lower normal value 11 ng/mL, may be enough to get haemoglobin to the normal level and function, but it seems not enough for normal functions of other different organs as the hair, muscles, brain, which could be the reason of hair lose, general weakness, fatigue, depressed mode, . ect although haemoglobin is normal and s. ferritin is low or in lower normal value.

No relevant conflicts of interest to declare.