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Faheema Hasan: ASH’s 2026 Guidelines on the Diagnosis of Iron Deficiency is out!

Faheema Hasan/LinkedIn

Sep 19, 2026, 09:38

Faheema Hasan: ASH’s 2026 Guidelines on the Diagnosis of Iron Deficiency is out!

Faheema Hasan, Associate Professor at United Medicity, shared a post on LinkedIn:

“What is new in Hematology?

The recent American Society of Hematology’s 2026 guidelines on the diagnosis of iron deficiency is out!

For years we’ve anchored to ferritin low or equal 12–15 ng/mL as the diagnostic line. The panel reviewed the evidence and concluded those thresholds were never evidence-based to begin with they were inherited.

Here’s what changes:

Children 9 months – 4 years: ferritin low or equal 20 ng/mL (up from low or equal 12)
Adults: low or equal 30 ng/mL (up from low or equal 15) – and low or equal 50 ng/mL if there are symptoms or ongoing risk factors
Menstruating individuals: low or equal 30 ng/mL, with low or equal 50 ng/mL where there is heavy menstrual bleeding, planned surgery, or pregnancy being planned
Pregnancy: low or equal 30 ng/mL – and a strong recommendation against using low or equal 15 ng/mL, the only strong recommendation in the document
Anemia of inflammation: ferritin alone is not enough. Pair it with a fasting TSAT. Consider iron deficiency if TSAT is low 20% or ferritin is low 100 ng/mL

For India, where iron deficiency is near-endemic in women and young children, the practical implication is simple: a ferritin in the teens or twenties in a symptomatic menstruating woman is not reassurance.

It is a diagnosis.

Worth a read, and worth a conversation with our lab colleagues about the reference ranges printed on our reports.”

Faheema Hasan