Evidence check: Ferritin in the context of menopause

Ferritin is a key marker of body iron stores. During menopause, iron metabolism changes significantly: with the cessation of menstruation, the monthly iron loss stops, so iron stores tend to increase. A higher ferritin level in menopause is not automatically pathological but can be a physiological adaptation. However, ferritin is also an acute-phase reactant—it rises with inflammation, infection, or liver disease, independent of iron status. An isolated elevated ferritin without measurement of transferrin saturation, CRP, and liver enzymes is clinically inconclusive. Moreover, postmenopausal women have a lower risk of iron deficiency but a higher risk of iron overload (e.g., hemochromatosis). Routine iron supplementation without prior lab testing is not indicated in this life stage and may even be harmful. The evidence base relies on clinical practice and population studies, not on specific genetic tests. Therefore, individual medical evaluation before any supplementation is essential.