The body begins to upregulate iron absorption at a ferritin concentration of less than 50 µg/L, indicating an incipient iron deficiency in young women.

2021 EClinicalMedicine Threshold ferritin and hepcidin concentrations indicating early iron deficiency in young women based on upregulation of iron absorption Galetti V, Stoffel NU, Sieber C, Zeder C, Moretti D, Zimmermann MB

Cohort Study Ferritin Hepcidin Iron Absorption

In the methodology, this study utilizes a pooled analysis of stable iron isotope studies conducted between 2006 and 2019 on healthy women aged 18 to 50. These studies quantified iron absorption from meals providing physiological quantities of iron. A mathematical model known as generalized additive modeling was employed to ascertain the relationships between iron absorption, ferritin, and a molecule called hepcidin. By estimating the first derivatives of the trend created by the model, inflection points (or thresholds) in these relationships were established.

The results revealed that hepcidin increased in a linear fashion parallel to ferritin. Iron absorption increased when hepcidin reached a threshold value and when a threshold ferritin value was detected, beyond which iron absorption remained stable. An auxiliary validation within the results found that a hepcidin of approximately 3 nmol/l corresponded to a ferritin level of approximately 51 µg/l. These findings collectively suggest that if the body's ferritin concentration falls below 50 µg/L—corresponding to a hepcidin level of less than 3 nmol/l—the body will respond by absorbing more iron from the diet, signaling an emerging iron deficiency.

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Children with attention-deficit hyperactivity disorder are found to have lower ferritin levels and are more likely to have iron deficiency.

2018 Scientific Reports Peripheral iron levels in children with attention-deficit hyperactivity disorder: a systematic review and meta-analysis Tseng PT, Cheng YS, Yen CF, Chen YW, Stubbs B, Whiteley P, et al.

Meta-Analysis ADHD Ferritin Iron Deficiency

For the methodology of this meta-analysis, numerous databases such as PubMed, ScienceDirect, Cochrane CENTRAL, and ClinicalTrials.gov were searched for relevant studies up until August 9, 2017. The principal outcomes were the differences in peripheral iron levels between children diagnosed with ADHD and healthy controls, and the severity of ADHD symptoms in children with and without iron deficiency. Seventeen articles met the strict inclusion criteria and were therefore included in the meta-analysis.

Discussing the results, peripheral serum ferritin levels (a measure of iron storage) were found to be significantly lower in children with ADHD. However, no notable difference was found in serum iron or transferrin levels (measures of iron transport). In addition, children with iron deficiency displayed more severe ADHD symptoms. Importantly, a significant link between ADHD and iron deficiency was also established.

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Maintenance of sufficient vitamin D status may be important in preventing anemia, particularly in diseases characterized by inflammation.

2015 Current Opinion in Endocrinology, Diabetes & Obesity Vitamin D and anemia Smith EM, Tangpricha V

Review Article Ferritin Vitamin D

Vitamin D has previously been found to be associated with anemia in various healthy and diseased populations. Recent studies indicate that the association may differ between race and ethnic groups and is likely specific to anemia of inflammation. The mechanism underlying this association involves the reduction of proinflammatory cytokines by vitamin D and the direct suppression of hepcidin mRNA transcription. There is also evidence that vitamin D may be protective against anemia by supporting erythropoiesis. Other calciotropic hormones including fibroblast growth factor 23, and parathyroid hormone have also been found to be associated with iron homeostasis and erythropoiesis.

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Female neonates show significantly higher cord serum ferritin concentrations than male neonates, and this difference is crucial when assessing their iron nutriture post-birth.

1999 Neonatology Gender Difference in Cord Serum Ferritin Concentrations Tamura T, Hou J, Goldenberg RL, Johnston KE, Cliver SP

Clinical Study Ferritin

The researchers measured cord serum ferritin concentrations in a total of 255 infants, divided into 116 females and 139 males. The study evaluated the relationship between these ferritin values and a series of neonatal and maternal characteristics. Notably, the study also considered specific groups such as infants with fetal growth restriction, infants with birth weights lower than 3,000g and infants with young or African American mothers.

In the study, a significant correlation was discovered between the maternal serum ferritin concentration at the 36-week gestation mark and the cord serum ferritin of male infants, while the same association was found to be less significant in the case of female infants. The mechanism behind this gender difference in ferritin concentration is not yet fully understood.

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