Common mistakes around ferritin and nutrition: Many people misinterpret a low ferritin level as iron deficiency without considering that ferritin is also an acute-phase reactant – during inflammation or infection it can be elevated while storage iron is actually low. Conversely, high ferritin is often equated with iron overload, though it can rise due to metabolic syndrome, alcohol consumption, or liver disease. Another mistake is indiscriminate iron supplementation without measuring transferrin saturation and CRP. Also, assuming that plant-based (non-heme) iron is absorbed as efficiently as heme iron leads to suboptimal therapy. Additionally, it is often forgotten that vitamin C enhances non-heme iron absorption, while tannins (tea, coffee) and phytates (whole grains) inhibit it. The evidence is mostly practice-based and guideline-oriented, not supported by strong RCTs. Caveat: Ferritin alone is not a reliable marker of iron status without inflammatory markers.
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