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Ferritin

Anemia Biomarker

Sample Needed

Collection Type: Blood

Body System

Related System: Anemia

Overview

Ferritin is an intracellular protein that stores iron and releases it in a controlled fashion; serum ferritin concentration reflects the body’s iron stores and is the most useful single test to assess iron status. The ferritin test measures circulating ferritin in blood to help detect iron deficiency, iron overload (hemochromatosis), and assess inflammation or chronic disease. It is ordered when symptoms such as fatigue, pallor, shortness of breath, pica, heavy menstrual bleeding, or unexplained liver enzyme elevations occur. Normal ferritin varies by age, sex and physiologic state: menstruating women and young children typically have lower values, pregnancy lowers ferritin, and elderly or chronically ill patients may have higher levels due to inflammation.

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Test Preparation

No special preparation is required

Why Do I Need This Test

Profile: included in the Anemia profile (iron studies).
Symptoms prompting test: persistent fatigue, pallor, breathlessness, heavy periods, restless legs, or suspected iron overload.
Diagnoses/monitoring: iron deficiency anemia, response to iron therapy, hemochromatosis, and monitoring inflammation or chronic disease.
Causes of abnormal levels: low = depleted iron stores/bleeding; high = iron overload, inflammation, liver disease, metabolic syndrome, malignancy.
Biological meaning: low ferritin = low iron storage; high ferritin = excess iron or acute-phase reactant.
Lifestyle/family: heavy menstrual loss, poor diet, frequent blood donation, multiple transfusions, family history of hemochromatosis warrant testing.

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Understanding Test Results

Low values: ferritin <15 ng/mL (some labs use <12–15 ng/mL) is highly specific for iron deficiency and indicates depleted iron stores; 15–30 ng/mL is suggestive/early deficiency and should be correlated with hemoglobin, MCV and clinical signs.
Moderate-low (30–50 ng/mL) may still reflect low stores in symptomatic patients.
High values: ferritin >150 ng/mL in women or >300–400 ng/mL in men is considered elevated; such levels may indicate iron overload when transferrin saturation is also high and there is compatible history (hereditary hemochromatosis, multiple transfusions).
Ferritin 500–1000+ ng/mL often reflects significant iron excess, severe liver disease, chronic inflammation, malignancy, or macrophage activation syndromes; values >1000 ng/mL strongly suggest severe inflammatory states or massive iron overload and require urgent evaluation.
Because ferritin is an acute-phase reactant, mildly elevated levels can occur with infection, autoimmune disease, obesity, or alcohol-related liver injury even without iron overload.
Interpretation should combine ferritin with CBC, transferrin saturation, CRP/ESR and clinical context.

Normal Range

Men: 30-400 ng/mL OR 30-400 µg/L Women: 15-150 ng/mL OR 15-150 µg/L

FAQs

Q: What happens if ferritin is very low?

A: Very low ferritin means depleted iron stores and often causes iron‑deficiency anemia. Symptoms include fatigue, weakness, breathlessness, paleness, rapid heartbeat, dizziness, poor concentration, restless legs, hair loss and brittle nails. If untreated it lowers exercise tolerance and can impair immunity. Diagnosis needs blood tests and investigation for bleeding; treatment involves dietary changes, oral or IV iron and treating the underlying cause.

Q: What is the problem if ferritin is high?

A: High ferritin usually signals iron overload or an acute‑phase/inflammatory response. Causes include hereditary hemochromatosis, chronic liver disease, heavy alcohol use, metabolic syndrome, infections, or malignancy. Persistently high ferritin with high transferrin saturation suggests true iron excess risking liver, heart, and pancreas damage; isolated high ferritin with normal saturation often reflects inflammation. Further evaluation is needed.

Q: What does ferritin level tell you?

A: Ferritin measures the body’s stored iron. Low ferritin indicates depleted iron stores and is the earliest lab sign of iron deficiency, often causing fatigue and anemia. High ferritin can reflect iron overload (e.g., hemochromatosis) or act as an acute‑phase reactant in inflammation, infection, liver disease, or metabolic syndrome. Results are interpreted alongside CBC, transferrin saturation and inflammatory markers.

Q: How do you increase ferritin levels?

A: Increase ferritin by eating iron-rich foods (red meat, poultry, fish, beans, lentils, leafy greens, iron-fortified cereals) and combining them with vitamin C to boost absorption. Avoid tea, coffee and calcium around meals. Treat blood loss or inflammation. Use oral iron supplements—or IV iron when prescribed—and have ferritin and haemoglobin checked periodically under your clinician’s guidance.

Q: What cancers cause low ferritin?

A: Low ferritin (iron deficiency) in adults often signals chronic blood loss, commonly from gastrointestinal cancers colorectal, stomach (gastric) and esophageal and from gynecologic malignancies such as endometrial or cervical cancer. Urinary tract cancers (bladder, kidney) that cause hematuria can also lead to low ferritin. Unexplained low ferritin warrants evaluation for these sources of occult bleeding.

Q: What to avoid when ferritin is low?

A: Avoid foods and habits that block iron absorption: don’t drink tea or coffee with meals, avoid milk or calcium supplements at the same time, and limit high‑phytate/oxalate foods (unsoaked whole grains, raw legumes, spinach) with iron‑rich meals. Also avoid antacids or proton‑pump inhibitors close to iron supplements and discuss drug interactions (e.g., some antibiotics) with your clinician—space items by 1–2 hours.