Sep 17, 2024

Guidelines for the Use of Laboratory Tests for Iron Deficiency

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Created by the Ontario Association of Medical Laboratories (OAML), led by Paul Gould, with input from LMP Quality Council members, Dr. Michelle Sholzberg, Dr. Lusia Sepiashvili, and leadership from Ontario Laboratory Medicine Program (OLMP), Lifelabs, Dynacare, AlphaLabs and laboratories across the province and country.

Iron deficiency is the most prevalent micro-nutritional deficiency in the world. Iron deficiency may present with or without anemia. Iron deficiency without anemia often goes unrecognized and is associated with symptoms that can negatively affect health related quality of life.

The lower limit of ferritin, the protein that stores iron, was previously a reference range that varied significantly between laboratories based on the assays used (from under 5 to under 15 micrograms per litre). The lower limit has now moved from a reference range to a clinical decision limit of 30 micrograms per litre for adults and 20 micrograms per litre for children. This change will help clinicians identify iron deficiency sooner and treat it.

The guidelines in this document are in alignment with the Raise the Bar campaign, which was developed to increase awareness of the high prevalence of iron deficiency, particularly in women, and to improve the diagnosis and treatment of this correctable disorder.

Download the guidelines from the OAML

Authors / contact

Compiled by the task force Raise the Bar: A quality improvement project to improve the diagnosis and management of iron deficiency and anemia

Dr. Michelle Sholzberg

Dr. Lusia Sepiashvili

Dr. Rita Selby

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