Evidence check: Ferritin Eisenmangel in the context of menopause

Ferritin is a key biomarker for iron stores. In menopause, iron deficiency can occur, especially due to heavy or irregular bleeding. However, ferritin is an acute-phase reactant; it can be falsely elevated during inflammation, masking a true deficiency. Therefore, diagnosis should rely on multiple parameters (e.g., transferrin saturation, hemoglobin, CRP). Genetic tests for iron deficiency (e.g., HFE, TMPRSS6) have only moderate evidence and are not recommended in routine clinical practice. Guidelines suggest measuring ferritin in menopausal women with symptoms like fatigue or poor concentration, but interpretation requires clinical context. A standalone DNA test for 'iron deficiency risk variants' is insufficient to justify therapy (e.g., iron supplementation). The evidence for the utility of such tests in menopause is weak to moderate. Caveat: ferritin levels below 30 µg/L indicate iron deficiency, but reference ranges vary. If iron deficiency is suspected, consult a physician before taking supplements.