Nawsherwan Mohammad: ASH 2026 Guidelines Redefine How We Detect Iron Deficiency
Nawsherwan Mohammad, Consultant Hematopathologist at Nanakaly Hospital, shared a post on LinkedIn:
“For years, patients have been told their iron is ‘normal’ while dealing with debilitating fatigue, brain fog, and poor concentration.
But here’s the catch: those old ‘normal’ ranges were often built from populations that included people who were already iron deficient. So ‘normal’ wasn’t always truly normal.
Now, the American Society of Hematology (ASH) has released its first-ever evidence-based clinical practice guidelines for iron deficiency – and this is a major shift.
The goal: catch iron depletion long before overt anemia develops.
What’s new in the ASH 2026 guidelines:
- Moving from lower limits of normal (LLNs) to Clinical Decision Limits (CDLs). Labs should flag true iron depletion – not just outliers on a population bell curve.
Updated serum ferritin thresholds:
- Children 9 months–4 years: less than or equal to 20 ng/mL (up from less than or equal to 12)
- Adults and menstruating individuals: less than or equal to30 ng/mL (up from less than or equal to 15)
- Pregnancy: less than or equal to 30 ng/mL, with strong advice against using less than or equal to 15
- High-risk threshold: less than or equal to 50 ng/mL for heavy menstrual bleeding, upcoming surgery, preconception planning, or pregnancy with concurrent anemia.
- Inflammation matters: ferritin can rise in inflammatory states like IBD, CKD, and cancer, masking deficiency. ASH recommends testing both ferritin and transferrin saturation (TSAT). Iron deficiency should be diagnosed if ferritin is less than 100 ng/mL or TSAT is less than 20%.
Why this matters:
This isn’t just a lab update. It’s a call to action for primary care clinicians, pathologists, labs, and health systems. We need to look beyond hemoglobin and treat the patient – not just the flag.”
Stay updated with Hemostasis Today.
-
Sep 19, 2026, 10:21Upcoming Podcast on Thalassaemia with The Lancet Haematology
-
Sep 19, 2026, 10:20Steve Helm: Cardiology and Anticoagulation Pharmacist Role Opens Near NYC
-
Sep 19, 2026, 10:12Omid Seidizadeh: A Great Pleasure to Speak on vWD at the 59th NordCoag Congress
-
Sep 19, 2026, 10:08Carsten Hansen: What Happens During a Sickle Cell Crisis?
-
Sep 19, 2026, 10:05Alan Nurden: Thyroid Hormones as Regulators of Acute Platelet Release
-
Sep 19, 2026, 10:02Oliver Weingärtner: What Can Real-World Data Teach Us about Long-Term Treatment Persistence in CP?
-
Sep 19, 2026, 09:55Ammar Alsughayir: When Transfusion Safety Becomes a Lifelong Commitment
-
Sep 19, 2026, 09:53Dilini Christina Ranasinghe: Exploring Red Cell Exchange in Sickle Cell Disease
-
Sep 19, 2026, 09:48Kanchal Mahesh: A First Step Into the World of Research