Ferritin Screening Program Information

What Is Ferritin?

Ferritin is the most common index of iron stores in the body. Blood iron is essential for hemoglobin production, and as such, has a direct link to oxygen transport to working muscles. If iron stores are low, an athlete can experience decreases in VO2max and aerobic power. Screening for ferritin values can assist in preventing the onset of iron-deficiency anemia. Screening endurance athletes for ferritin and hemoglobin levels is recommended in female athletes and male endurance athletes.

Female endurance athletes are 2-5 times more at risk for reduced iron stores than male athletes. Some of the reasons for this (beyond blood loss from menstruation) are: hemolysis from heel strike and impact; gastrointestinal iron losses; iron loss from sweat; poor dietary intake of iron-containing foods; and altered absorption of iron possibly due to the effects of inflammation during training.

By addressing ferritin levels preventively, this will likely reduce the risk of experiencing decreases in oxygen transport and aerobic capacity.

Frequently Asked Questions About Ferritin

If I get an email asking me to complete a ferritin screening questionnaire, do I need to complete it?

If you would like your blood tested for ferritin/iron status, you do need to complete the online questionnaire. Information from the questionnaire helps to target recommendations and better understand other contributing factors that may affect your iron status. If you choose not to complete the questionnaire, the Department of Sports Medicine will assume you are "opting out" of this screening opportunity.

If I "opt-out" of getting my ferritin screened, will I be able to do it another time?

All teams that have been identified for ferritin screenings will be given at least 1 time each academic year to "opt in" to have their ferritin values tested. If you choose to decline the opportunity when it is presented, you will not be offered another opportunity until the following year. If you present with symptoms and decide you would like your ferritin tested, you can speak to your Athletic Trainer about how to get this value tested.

Once I complete the questionnaire, what happens next?

Screening for ferritin is a three-part, "opt-in" process.

  • Online questionnaire: The first-part requires that you complete an online questionnaire that has been sent to your Health Portal account. Once you complete and submit this questionnaire, Dr. Karlson will order a blood draw for you to complete
  • Blood draw: Part-two requires that you schedule to have your blood drawn before a designated deadline. Scheduling for a blood draw can be done online by using the Dick's House online scheduling link or can be done by calling to schedule an appointment at 603-646-9401.
  • Recommendations and follow-up: Once the results are back, Dr. Karlson will Secure Message you this information and any recommendations that you are to follow. It is your responsibility to follow the recommendations made in order to improve your ferritin status. You are also responsible for scheduling any follow-up suggested for a re-check of your ferritin levels. It is not advisable (and potentially dangerous) to continue taking an iron supplement when your values do not indicate a need.

 Is there a cost to having this screening test done?

There is no cost to you as an athlete. This service is being provided jointly by Dartmouth College Health Services and Dartmouth College Athletics.

Will a ferritin screening potentially lead to other screenings through Athletics?

Yes, depending on both your responses to the questionnaire and the results of your ferritin tests, there may be a need to refer you for a Relative Energy Deficiency in Sport RED-S) assessment. This is a more comprehensive assessment of your health as an athletic and may lead to recommendations on dietary or other changes that could further improve your performance and long-term health. If a RED-S assessment is recommended, you will be contacted by a member of the Sports Medicine RED-S team and given instruction as to how to proceed in scheduling this.

What are the common ways to improve ferritin levels?

Low Ferritin: If your ferritin levels are low (typically lower than 50), you will be asked to follow up with your Sports Dietitian to discuss further ways to improve your dietary consumption of iron and enhance iron absorption. Read more about Dietary Sources of Iron.

Depending on how low your ferritin levels are (typically if lower than 30) you may also be asked to begin taking an oral iron supplement. Review Facts on Iron Supplementation for more detailed information on what your options are. If you begin an iron supplement, it is important that you follow-through on the recommendations for re-check of ferritin values. Please know that going beyond 3 months on an iron supplement without confirming your ongoing need for it could eventually lead to toxic effects.

High Ferritin: If your ferritin levels are too high, you will be asked to meet with Dr. Karlson to further investigate this issue.