Biomarkers · Inflammation
Serum Ferritin
U-shaped: both low and high values carry risk. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation is associated with a hazard ratio of 1.09. U-shaped: slope not comparable
NHANES, our fit with 95% CIPublished curve
Hazard ratios relative to each curve's own reference value, so the two curves need not cross 1 at the same point. The dotted vertical line marks the NHANES median.
NHANES hazard per SD1.0995% CI 1.04–1.15 · 19,200 adults, 2,567 deaths
Published hazard ratio1.40top vs bottom third (95% CI 1.20–1.64) · Copenhagen City Heart Study (General Population)
Where people sit
Population percentiles (ug/L) by sex and age band. Cycle or source as recorded in the catalogue.
| Sex | Age | 5th | 25th | Median | 75th | 95th | n | Cycle / source |
|---|---|---|---|---|---|---|---|---|
| All | 20-39 | 11.0 | 32.0 | 72.0 | 138 | 330 | 2,580 | 2017-2018 |
| All | 40-59 | 15.0 | 48.0 | 104 | 192 | 445 | 2,550 | 2017-2018 |
| All | 60+ | 20.0 | 60.0 | 122 | 218 | 490 | 2,670 | 2017-2018 |
| All | all | 14.0 | 45.0 | 98.0 | 182 | 425 | 7,800 | 2017-2018 |
| Men | all | 32.0 | 82.0 | 145 | 242 | 515 | 3,780 | 2017-2018 |
| Women | all | 10.0 | 28.0 | 62.0 | 124 | 295 | 4,020 | 2017-2018 |
What studies found when this marker was changed
Effects on the biomarker reported in the cited studies. They describe what happened in those populations, not a recommendation for anyone. See all catalogued interventions.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| behavioral | Therapeutic phlebotomy / Blood donation in iron overload states | Lowers serum ferritin into optimal 50-150 ug/L range | RCT | National Center for Health Statistics. National Health and Nutrition Examination… |
| clinical | Therapeutic phlebotomy / regular voluntary blood donation in iron overload | -30% to -60% reduction (50-100 ng/mL drop per unit) | rct | Houschyar KS, et al. BMC Med. 2012;10:54. |
| clinical | Genetic Hemochromatosis (HFE C282Y mutation homozygosity) | +300% to +1000% elevation (>800 ng/mL) | clinical guideline | Bacon BR, et al. Hepatology. 2011;54:328-343. |
| diet | Dietary restriction of heme iron and red meat intake | -15% to -35% reduction in hyperferritinemic states | rct | Fleming DJ, et al. Am J Clin Nutr. 2002;76:1375-1384. |
| nutraceutical | Oral iron supplementation (Ferrous sulfate / bisglycinate) in iron deficiency | +20 to +50 ng/mL increase from deficient baseline | meta-analysis | Stoffel NU, et al. Lancet Haematol. 2017;4:e524-e533. |
| nutraceutical | High-dose chronic unmonitored iron supplementation | +100% to +300% elevation causing tissue hemosiderosis | prospective cohort | Sullivan JL. Lancet. 1981;1:1293-1294. |
Sources
- Hazard curve: Recalculated from mortality_association (HR=1.4 tertile_extreme); per-SD log(HR)=0.2283.
- Ellervik C, et al. Elevated serum ferritin and risk of premature death: a prospective general population study. J Intern Med. 2014;275(4):379-390.
- Empirical curve: our Cox model with age and sex, NHANES 1999–2018 with linked mortality to 2019.