The DOI matches its Crossref record; 43 of the 45 references it cites were found in a registry or an index.
Serum ferritin as an indicator of iron status: what do we need to know?
Open accessAbstract
Determination of iron status in pregnancy and in young children is essential for both clinical and public health practice. Clinical diagnosis of iron deficiency (ID) through sampling of bone marrow to identify the absence of body iron stores is impractical in most cases. Serum ferritin (SF) concentrations are the most commonly deployed indicator for determining ID, and low SF concentrations reflect a state of iron depletion. However, there is considerable variation in SF cutoffs recommended by different expert groups to diagnose ID. Moreover, the cutoffs used in different clinical laboratories are heterogeneous. There are few studies of diagnostic test accuracy to establish the sensitivity and specificity of SF compared with key gold standards (such as absent bone marrow iron stores, increased intestinal iron absorption, and hemoglobin response to SF) among noninflamed, outpatient populations. The limited data available suggest the commonly recommended SF cutoff of <15 μg/L is a specific but not sensitive cutoff, although evidence is limited. Data from women during pregnancy or from young children are especially uncommon. Most data are from studies conducted >30 y ago, do not reflect ethnic or geographic diversity, and were performed in an era for which laboratory methods no longer reflect present practice. Future studies to define the appropriate SF cutoffs are urgently needed and would also provide an opportunity to compare this indicator with other established and emerging iron indexes. In addition, future work would benefit from a focus on elucidating cutoffs and indexes relevant to iron adequacy.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“It is a usual practice in many specialties and guidelines to assume that, regardless of the lower normality value of the ferritin test used, SF <30 ng/mL (irrespective of the TSAT value) or SF <100 ng/mL and TSAT <20% are the hallmarks of absolute ID; while SF >100 ng/mL and TSAT <20% usually indicate AI in the context of infection or inflammation [1,2,15,16,17,18,19,20].”
From Defining Global Thresholds for Serum Ferritin: A Challenging Mission in Establishing the Iron Deficiency Diagnosis in This Era of Striving for Health Equity (2025) · cites this paper as [20]
In the citing paper
“Although many laboratory indexes may be helpful for the ID differential diagnostic workup, such as the mean corpuscular volume (MCV), the reticulocyte count and reticulocyte Hb content, the soluble transferrin receptor and its correlation with SF, and hepcidin measurement, based on the real-life evidence, the determination of iron status by using SF and TSAT is the most commonly deployed strategy”
From Defining Global Thresholds for Serum Ferritin: A Challenging Mission in Establishing the Iron Deficiency Diagnosis in This Era of Striving for Health Equity (2025) · cites this paper as [20]
Citations
Cites
The meaning and use of the area under a receiver operating characteristic (ROC) curve.
Hanley, J. A., & McNeil, B. J. (1982) · Radiology · doi:10.1148/radiology.143.1.7063747 · Cited by 21,856
Kirkwood, B. R., & Sterne, J. A. C. (2014) · Bristol Research (University of Bristol) · Cited by 2,820
Estimation of the Youden Index and its Associated Cutoff Point
Fluss, R., Faraggi, D., & Reiser, B. (2005) · Biometrical Journal · doi:10.1002/bimj.200410135 · Cited by 2,656
Diagnostic tests 4: likelihood ratios
Deeks, J. J., & Altman, D. G. (2004) · BMJ · doi:10.1136/bmj.329.7458.168 · Cited by 1,600
Recommendations to Prevent and Control Iron Deficiency in the United States
(1998) · PsycEXTRA Dataset · doi:10.1037/e547762006-001 · Cited by 816
Bacon, B. R., Adams, P. C., Kowdley, K. V., Powell, L. W., & Tavill, A. S. (2011) · Hepatology · doi:10.1002/hep.24330 · Cited by 737
Muckenthaler, M. U., Galy, B., & Hentze, M. W. (2008) · Annual Review of Nutrition · doi:10.1146/annurev.nutr.28.061807.155521 · Cited by 701
UK guidelines on the management of iron deficiency in pregnancy
Pavord, S. R., Myers, B., Robinson, S. E., Allard, S., Strong, J., & Oppenheimer, C. A. (2012) · British Journal of Haematology · doi:10.1111/j.1365-2141.2011.09012.x · Cited by 620
Serum ferritin is derived primarily from macrophages through a nonclassical secretory pathway
Cohen, L. A., Gutierrez, L., Weiss, A., Leichtmann-Bardoogo, Y., Zhang, D.-L., Crooks, D. R., Sougrat, R., Morgenstern, A., Galy, B., Hentze, M. W., et al. (2010) · Blood · doi:10.1182/blood-2009-11-253815 · Cited by 452
(1998) · PubMed · Cited by 406
Research works printed but not linked: 2
- 2011, Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations., Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations.
- 2013, Iron studies standardised reporting protocol, Surry Hills (New South Wales): Royal College of Pathologists of Australasia
Cited by
Sorted by citations
Items 201–246 of 246
Widiyawati, R., Hafy, Z., & Liana, P. (2021) · Jurnal Surya Medika · doi:10.33084/jsm.v7i1.2303
Shareef, M. M., Abdulkareem, S. S., & Azeez, J. I. (2020) · Kirkuk journal of medical sciences · doi:10.32894/kjms.2020.169368
Ashiq, T., Hafeez, A., Sattar, A., Nasir‐ud‐Din, Saeed, N., & Mushtaq, F. (2021) · Pakistan Armed Forces Medical Journal · doi:10.51253/pafmj.v6i6.6855
Hong, F. S., Mo, A., Nasra, F., Sieradzki, N., Pollock, C., Willcox, A., Smith, C. S., & Khoon, W. (2018) · Internal Medicine Journal · doi:10.1111/imj.14098
Measures of Iron Metabolism and Applications to Dietary Patterns
Chang, J., Tinkov, A. A., Lundy, D. J., & Skalny, A. V. (2022) · Biomarkers in disease · doi:10.1007/978-3-030-81304-8_14-1
Risk factors of intensive care admission and mortality in a cohort of 111 Egyptian COVID-19 patients
Mohamed, E. R., Ragab, D., Taeimah, M., & Shaltoot, H. M. H. (2022) · Egyptian Journal of Anaesthesia · doi:10.1080/11101849.2022.2121479
Iron status and developmental delay among children aged 24–36 months
Ferdi, J., Bardosono, S., & Medise, B. E. (2022) · Paediatrica Indonesiana · doi:10.14238/pi62.4.2022.257-66
Iron status and developmental delay among children aged 24–36 months
Ferdi, J., Bardosono, S., & Medise, B. E. (2022) · Paediatrica Indonesiana · doi:10.14238/pi62.4.2022.256-64
Sari, N., Sulastri, D., & Endrinaldi, E. (2023) · Contagion Scientific Periodical Journal of Public Health and Coastal Health · doi:10.30829/contagion.v5i3.17395
Latent Iron Deficiency in Tender-Age Infants: Modern Preventive Measures
Belyaeva, I. A., Петровна, Б. Е., & Turti, T. V. (2023) · Педиатрическая фармакология · doi:10.15690/pf.v20i5.2634
Khaleq, M. A. A. (2023) · Journal of Medicine and Life · doi:10.25122/jml-2023-0209
Use of iron in perinatal anaemia: Indications for women’s health care policies and procedure
Etemady, M., Hajizadeh, M., Gidaszewski, B., Swain, J. A., Chua, S. C., & Khajehei, M. (2023) · World Journal of Obstetrics and Gynecology · doi:10.5317/wjog.v12.i4.33
Al-hamdani, G. M., & Yas, L. S. (2023) · Tikrit Journal for Dental Sciences · doi:10.25130/tjds.11.2.16
Deficiencia de ferritina en gestantes colombianas y factores sociodemográficos asociados
Lesmes, Ó. A. G., Tobón-Borrero, L. M., & Martínez-Torres, J. (2024) · Medicina UPB · doi:10.18566/medupb.v43n1.a06
THE ROLE OF SERUM FERRITIN IN ANAEMIA – A KEY DIAGNOSTIC MARKER OF IRON DEFICIENCY
Lamani, S., Naik, N. S., Shabnam, S., & Pinjar, P. M. (2024) · PARIPEX-INDIAN JOURNAL OF RESEARCH · doi:10.36106/paripex/7600803
Nutritional status and its relationship with COVID-19 prognosis in hemodialysis patients
Nieto, G., Reyes, P. B., Cana-Poyatos, A., Sanz, P. G., Maset, R. G., & García‐Testal, A. (2024) · Nutrición Hospitalaria · doi:10.20960/nh.04850
Iron deficiency anemia in reproductive-aged women: options for treatment and prevention
Валентиновна, Б. Е., Крутова, В. А., Валерьевна, Д. А., Prosolupova, N., & Дудникова, Э. В. (2023) · Vrach · doi:10.29296/25877305-2023-02-10
Kumar, A., Sharma, M., Frayez, M., & Rahman, A. (2024) · Indian Journal of Obstetrics and Gynecology Research · doi:10.18231/j.ijogr.2024.036
Hasabi, A., Farrokhpour, S., Fallahi, M., Tavanayan, M., Shahvari, S. Z., & Satarzadeh, M. (2024) · Research Square · doi:10.21203/rs.3.rs-4675696/v1
Namiot, E. D., Morozova, G. D., Русланович, С. А., Logvinenko, A., Викторович, Ю. В., & Skalny, A. V. (2023) · Molekulyarnaya Meditsina (Molecular medicine) · doi:10.29296/24999490-2023-03-03
Iron Deficiency in Preschool Children with Chronic Rhinitis
Lo, Y.-F., & Chang, J. (2024) · Pediatric Allergy Immunology and Pulmonology · doi:10.1089/ped.2024.0097
Zgliczyńska, M., Ostrowska, M., Żebrowska, K., Rzucidło-Szymańska, I., Szymusik, I., Kowalski, K., & Kosińska–Kaczyńska, K. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1487730
Ghoraba, A. K. M., Dwidar, A. M., Harras, F., Ahwal, L. E., Amer, R. S., & Mashaal, R. G. (2025) · Tanta Medical Journal · doi:10.4103/tmj.tmj_70_24
Mukasa, R., Nathan, M. V., Sekitoleko, I., Makanga, R., Nkabura, H., Ongaria, T. A., Mugamba, V., Nakanga, W. P., Nyirenda, M., & Niwaha, A. J. (2025) · medRxiv · doi:10.1101/2025.04.28.25326576
Blood Indicators and Hemoglobin Analysis Among Dialysis Patients in Basrah City, Iraq
Jamalludeen, N., Hashim, L. M., Mohammed, Z., & Jaber, B. N. (2025) · Biomedical & Pharmacology Journal · doi:10.13005/bpj/3180
Differential Regulation of Slc40a1, Fth1, and Hmox1 by Deferasirox in Splenic Iron Overload
Wibowo, A., Kuntana, Y. P., Arrizqiani, T., & Safitri, R. (2025) · Sciences of Pharmacy · doi:10.58920/sciphar0404386
Unger, H. W., Bleicher, A., Ome‐Kaius, M., Aitken, E. H., & Rogerson, S. J. (2022) · Figshare · doi:10.6084/m9.figshare.19906063
Ntenda, P. A. M., Chirambo, A. C., Nkoka, O., El-Meidany, W. M., & Goupeyou-Youmsi, J. (2022) · Figshare · doi:10.6084/m9.figshare.21258861
Ntenda, P. A. M., Chirambo, A. C., Nkoka, O., El-Meidany, W. M., & Goupeyou-Youmsi, J. (2022) · Figshare · doi:10.6084/m9.figshare.21258858
Wang, P.-C., Gussekloo, J., Arai, Y., Abe, Y., Blom, J. W., Duncan, R. C., Jagger, C., Kerse, N., Martin-Ruiz, C., Palapar, L., et al. (2021) · Figshare · doi:10.6084/m9.figshare.15139652
Rana, F., Sinha, A., Mishra, M., & Narayan, R. (2026) · Cureus · doi:10.7759/cureus.101429
Zhong, J., Chen, K. G., & Liu, C. (2025) · Nutrition Reviews · doi:10.1093/nutrit/nuaf296
Mao, Z., Zhu, Y., Lin, D., Su, L., Huang, T., Yang, W. O., & Sun, B. (2026) · Journal of Agricultural and Food Chemistry · doi:10.1021/acs.jafc.5c11614
Evaluation of Hepcidin and Iron-Biochemical Parameters in Pregnant Women in Samarra City
Samarrai, N. A.-A. A., & Samarrai, O. R. A. (2025) · Medical Journal of Babylon · doi:10.4103/mjbl.mjbl_911_23
Coetzee, A., Brown, K. L., Opie, J., Rusch, J. A., Kropman, A., & Louw, V. J. (2026) · Transfusion Medicine · doi:10.1111/tme.70068
Șufaru, I.-G., Burlea, L. Ş., Mârțu, M.-A., Solomon, S. M., Laza, M.-G., Păsărin, L., Teodorescu, A. C., & Mârţu, I. (2026) · Nutrients · doi:10.3390/nu18050845
Mora‐Gonzalez, D., Moreno‐Cabañas, A., García, L. G., Cobo‐Cuenca, A. I., Muñoz‐Turrillas, M. D. C., Mora‐Rodríguez, R., & Morales‐Palomo, F. (2026) · BMC Nursing · doi:10.1186/s12912-026-04662-4
Yang, X., Jiang, F., Deng, Q., Wang, X., Chen, X. C., Shi, H., & Li, Y. (2026) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2026.2673694
Patient blood management in pregnancy, the peripartum, and the postpartum period
Filho, A. L. D. S., Alves, Á. L. L., & Osanan, G. C. (2026) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.61622/rbgo/2026fps7
Pickler, M. C., Funderburk, L., Lee, K. M., Bolden, L. K., Chapman-Lopez, T. J., Heileson, J. L., & Gallucci, A. R. (2026) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000005584
CS-GIN: A cosine similarity-based graph isomorphism network for multi-class anemia classification
Suwarno, I., Ma'arif, A., Purwono, Raharja, N. M., Ratnaningsih, T., Mustaqim, T., & Saputra, D. C. E. (2026) · Array · doi:10.1016/j.array.2026.101063
Patient Blood Management na gravidez, no periparto e no pós-parto Número 7 – 2026
Filho, A. L. D. S., Alves, Á. L. L., & Osanan, G. C. (2026) · Femina · doi:10.61622/0100-7254545202605
Obesity‐Related Inflammation Masks Iron Deficiency in US Women
Aguree, S., & Tadikonda, S. C. (2026) · American Journal of Hematology · doi:10.1002/ajh.70496
The Association of Maternal Serum Ferritin with Preterm Labour
Jumaah, A. A., & ِِAl-Mahfooth, W. (2026) · Clinical Medicine And Health Research Journal · doi:10.18535/cmhrj.v6i05.634
Stanworth, S. J., Churchill, D., Bain, C., Hudson, C., Brown, R., Hounslea, E., Griffiths, J., Lax, S. J., Murray, J., Spiby, H., et al. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-122579
Self-citation
Metadata
- Authors
- Daru, J., Colman, K., Stanworth, S. J., De La Salle, B., Wood, E. M., & Pasricha, S.-R.
- Affiliations
- Queen Mary University of London (GB)
- Monash University (AU)
- NHS Blood and Transplant (GB)
- University of Oxford (GB)
- Corresponding author
- Pasricha, Sant-Rayn
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 106
- Issue
- Suppl 6
- Pages
- 1634S-1639S
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC5701723
- OpenAlex
- W2765394563
- Cited by
- 246
- References
- 45
- Citations by year
- 2026: 21 · 2025: 36 · 2024: 34 · 2023: 32 · 2022: 31 · 2021: 34 · 2020: 28 · 2019: 19 · 2018: 9 · 2017: 2
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- Funders
- Cooley's Anemia Foundation
- National Institute for Health and Care Research (ACF-2012-19-001)
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Keywords
- serum ferritin, iron status, iron deficiency, diagnostic thresholds, diagnostic accuracy, iron depletion, pregnancy, young children, bone marrow iron stores, hemoglobin response
- MeSH terms
- Child, Preschool, Female, Ferritins, Hemoglobins, Humans, Iron, Nutritional Status, Pregnancy, Receptors, Transferrin, Sensitivity and Specificity, Anemia, Iron-Deficiency
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review