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About Our Ferritin Test

Ferritin is found in virtually all cells of the body and serves as the cellular storage repository for iron. The majority of ferritin iron stores are found in the liver, spleen and bone marrow. This test is used to measure ferritin levels in the blood. Ferritin is an intracellular protein which plays a significant role in the adsorption, storage, and release of iron in the human body. Found mainly in the liver, bone marrow, and spleen the serum ferritin level is generally proportional to the total body iron stored in tissues and in the circulation. Serum ferritin is the best single test for the diagnosis of iron deficiency. It is also used to support diagnosis and follow therapy of patients with hemochromatosis, and distinguish iron deficiency anemias from other types. Ferritin is an acute phase reactant and may be elevated in a number of inflammatory conditions and infections.

Ferritin is present in small concentrations that correlate with total-body iron stores, making its measurement valuable for the assessment of disorders relating to iron metabolism. Ferritin fluctuates with iron levels; when iron levels are low, so are ferritin levels, which can cause symptoms of weakness, fatigue and dizziness. When there is an abundance of iron, there is an increase in ferritin, which can cause swelling of the liver and liver damage, fatigue, weight loss, weakness and sometimes darkening of the skin.

Low levels of Ferritin can be found when iron stores are exhausted, well before the serum iron level has become affected. In cases of anemia, low serum Ferritin is often a very specific indicator for iron-deficiency anemia.

More Information About Ferritin

Other than a bone marrow examination, serum ferritin is the most reliable indicator of total body iron stores. When combined with serum iron and percent saturation of iron binding capacity/transferrin, it can usually differentiate the microcytic hypochromic anemias into:

  • Iron deficiency anemia (ferritin low, iron low, saturation low, TIBC high, transferrin high)
  • Anemia of chronic disease (ferritin normal or high, iron low, normal to low transferrin or TIBC)
  • Thalassemia (ferritin normal or high)

High Levels of Ferritin

High serum ferritin may be associated with:

  • Inflammation
  • Liver disease
  • Alcoholism
  • Megaloblastic anemia
  • Hemolytic anemia
  • Sideroblastic anemia
  • Thalassemia
  • Iron overload (hemochromatosis, hemosiderosis)
  • Gaucher disease,
  • Hereditary hyperferritinemia cataract syndrome
  • Malignant diseases

The latter include leukemia and malignant lymphoma. Very high levels usually indicate iron overload but may also be seen with hemophagocytosis. Very high levels may also occur with hemophagocytosis and/or disseminated histoplasmosis in patients who have the acquired immunodeficiency syndrome. Oral and injected iron increase ferritin levels.

Clinical Uses

  • Detection of iron deficiency (iron-deficient anemia)
    • Blood loss
    • Inadequate iron intake
    • Increased iron utilization
    • Malabsorption (celiac disease, gastric bypass)
  • Detection of iron overload
    • Hemochromatosis
    • Sideroblastic anemia
    • Excess iron-storage disorder
    • Multiple transfusions
  • Monitor therapeutic response in iron deficiency and iron overload
  • Useful in the differential diagnosis of hypochromic, microcytic anemias
  • Useful in distinguishing iron-deficient anemia from anemia of chronic disease

Other than a bone marrow examination, serum ferritin is the most reliable indicator of total body iron stores. When combined with serum iron and percent saturation of iron binding capacity/transferrin, it can usually differentiate the microcytic hypochromic anemias into:

  • Iron deficiency anemia (ferritin low, iron low, saturation low, TIBC high, transferrin high)
  • Anemia of chronic disease (ferritin normal or high, iron low, normal to low transferrin or TIBC)
  • Thalassemia (ferritin normal or high)

Medically Reviewed by: 2019-09-04

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