Detecting iron deficiency early gives clinicians a chance to intervene before patients progress to anemia or continue to have symptoms. Powers said a central goal of the new thresholds is for more patients to be diagnosed, so that people who could benefit from iron therapy are not overlooked.
Building Ferritin Thresholds Into Laboratory Clinical Decision LimitsPowers said the panel is advocating for laboratories at institutions and national health organizations to adopt the new thresholds as clinical decision limits in their reference ranges. Results below the threshold would then be flagged automatically. She described this as an easy way to put the thresholds into practice and make it more feasible for clinicians to act on them.Multidisciplinary Panel Aims for Consistent Iron Deficiency Care
The panel included pediatric and adult hematologists, a neonatologist, a maternal-fetal medicine specialist, a pharmacist, and a patient representative. Members also brought expertise in cost effectiveness, transfusion and laboratory medicine, and guideline implementation.
Powers, a pediatric hematologist whose clinical work and research focus on iron deficiency in young children and adolescents, said a key goal was consistency. She wants generalists, primary care clinicians, and specialists to apply the thresholds in the same way, so patients receive more equitable care regardless of where they are treated.
When a Ferritin Threshold of 50 ng/mL May Be Appropriate
“There are high risk patient populations or individuals who might have risk factors that would benefit from using a higher threshold, and that’s really trying to capture some of the nuances, some of the symptoms that patients experience, or those patient populations for whom progressing very quickly from iron deficiency to iron deficiency anemia may occur unless they maintain a higher ferritin,” Powers said.
Although ≤30 ng/mL is the recommended threshold for most adult populations, the guideline notes that a higher threshold may suit patients with heavy menstrual bleeding or symptoms consistent with iron deficiency.¹ Powers encouraged clinicians to apply the guidance to each patient individually.
Editor’s Note: Powers reports no relevant disclosures.
ReferencesPowers JM, Lim MY, Achebe MO, et al. American Society of Hematology 2026 guidelines for diagnosis of iron deficiency. Blood Adv. 2026. doi:10.1182/bloodadvances.2025015950American Society of Hematology. ASH sets new standards for diagnosing iron deficiency. Medical Xpress. September 16, 2026. https://medicalxpress.com/news/2026-09-ash-standards-iron-deficiency.html