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Ferritin: What Your Levels Say About Iron Stores
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What is it?
Ferritin is the main iron-storage protein in the body and also rises when there is inflammation.
Low Ferritin is an indicator of iron deficiency anemia. Ferritin levels lower than 12-18 ug/L is diagnostic of iron deficiency; however, utilizing a ferritin of <30 ug/L is a more sensitive indicator of iron deficiency. Non-hematologic symptoms can occur when the serum ferritin is in the low normal range (< 30 ug/L).
Elevated Ferritin levels can indicate hemochromatosis, a malignancy, NASH, alcohol overuse, renal failure or metabolic syndrome. Moreover, In recent years, ferritin's role as an acute phase reactant linked to metabolic disorder has garnered increased attention.
Why it matters
It is important to interpret Ferritin in conjunction with a full iron panel and history as many different factors can cause ferritin to not be a reliable predictor of iron overload or anemia. For example, individuals can be anemic with an elevated ferritin if they have inflammation or thalassemia. Ethnicity also impacts normal ferritin levels. Individuals of East Asian, African and Caribbean descent are much more likely to have elevated Ferritin levels without the hemochromatosis gene.
Reference ranges
- There is consensus that a ferritin of 500 ug/L -600 ug/L requires investigation for iron overload
- Ferritin levels between 200 ug/L-500 ug/L for women and 300 ug/L -500 ug/L for men are elevated but do not warrant investigation for iron overload unless coupled with a TSAT of >45% 134,135 Ferritin in these ranges is likely due to inflammation.
- Ferritin levels <30 ug/L should be screened for iron deficiency.
- There is no universal consensus on optimal ferritin levels, however the BC Clinical Practice Guidelines suggest an optimal range of 100 or above, noting that above 200ug/L in women and greater than 300ug/L for men may be associated with inflammation or iron overload if combined with other markers of high iron. Other studies also suggest targeting an optimal level of 100ug/L for patients without inflammation, particularly if individuals are experiencing symptoms that may be related to iron deficiency.'
This information is educational and does not replace medical advice, diagnosis, or treatment. Your results should be interpreted with a qualified healthcare professional in the context of your health history.
