American Society of Hematology issues new iron deficiency guidelines

The American Society of Hematology (ASH) has released its first guidelines for diagnosing iron deficiency, establishing new serum ferritin thresholds to prevent missed diagnoses. The panel, led by guideline chair Jacquelyn M. Powers, MD, MS, aims to address the issue where current laboratory reference ranges may label low ferritin levels as ‘normal,’ causing clinicians to overlook iron deficiency in patients who do not yet have anemia.

The new recommendations suggest a serum ferritin threshold of ≤30 ng/mL for most adults, including pregnant and menstruating individuals, and ≤20 ng/mL for children aged 9 months to 4 years. The guidelines note that a threshold of up to 50 ng/mL may be appropriate for certain patients to ensure they feel better and continue to absorb iron effectively.

By focusing on iron deficiency itself rather than just iron deficiency anemia, the guidelines allow for earlier clinical intervention. The ASH panel is also encouraging laboratories to integrate these new thresholds directly into clinical reports to assist busy providers in identifying at-risk patients.