Preventive Healthcare

Ferritin Test: Purpose and Making Sense of Results

Ferritin is an intracellular protein present in most tissues which plays an important role in the storage of intracellular iron, however being a subject of extensive research recently, various other roles have also been ascribed to it. A ferritin test helps measure levels of iron your body could store.

How Does Ferritin Help?

The serum ferritin is an indirect measure of the total body iron stores and makes a very effective iron delivery system.

Ferritin test is a valuable tool for the clinician, both for evaluation of iron-deficiency anemia, and also for evaluation of iron-overload conditions, such as hereditary hemochromatosis and chronic transfusion therapy.

Ferritin Test: Making Sense of the Results

Ferritin Test for Iron levels

Ferritin serum test is usually a part of a panel of several blood tests routinely ordered to diagnose and manage iron deficiency anemia.  If a ferritin test indicates that your level is lower than normal ferritin levels, it indicates your body’s iron stores are low and you may have iron deficiency. You could be anemic. However as normal ferritin levels change according to various physiological and pathological conditions, its values must be judged with caution.

Low serum ferritin is highly specific for iron deficiency anemia, and is much more convenient than the gold standard method of obtaining a bone marrow biopsy to assess stainable iron. Ferritin normal range varies across laboratories, but levels of 30 to 300 ng/ml are considered normal for men, and 10–200 ng/ml for women. Studies suggested that a level higher than approximately 40 ng/ml should be used to exclude iron deficiency in most patients, whereas a level higher than 70 ng/ml is more appropriate to exclude iron deficiency in patients with inflammation or liver disease where serum ferritin levels are raised as a nonspecific marker of illness.

Common Iron Deficiency Anemia Symptoms to Look for:

  • Feeling extremely tired is one of the most common symptoms of anemia due to iron deficiency.
  • Paleness is more commonly seen in moderate or severe cases of anemia. It is often the most obvious symptom too. Just pull your lower eyelid down while looking at yourself in a mirror, the inner layer should be a vibrant red color. If it’s a very pale pink or yellow, it may indicate low iron levels. However, make sure to confirm this with a blood test.
  • Running out of breath when doing even easy daily tasks like walking, climbing stairs, or working out.
  • Irregular heartbeats
  • Dry mouth or a swollen, inflamed, pale, or strangely smooth tongue.

Ferritin Test in COVID

Ferritin test, in the light of COVID-19 pandemic, has also emerged as an important diagnostic marker. As a mediator of cytokine storm, a form of extreme immune dysregulation associated with fatal outcomes, it is usually ordered as a part of a panel along with other inflammatory markers like ESR, CRP, D dimer and IL-10. Many studies have correlated high ferritin levels with severe COVID disease. In a small study with 20 people with COVID-19, it was found that individuals with severe and very severe COVID-19 exhibited increased serum ferritin level. However, your doctor is the guide here, always follow diagnostic and treatment related guidelines advised to you.

Ferritin Test for kidney Conditions

In patients with chronic kidney disease serum ferritin is a less robust marker of bioavailable iron. Although most patients on maintenance haemodialysis have a serum ferritin >500 ng/ml, this level does not represent the bioavailable iron and guidelines propose a serum ferritin level of 800 ng/ml as an upper limit for intravenous iron therapy whereas absolute iron deficiency is defined using another laboratory measure (transferrin saturation <20%) or serum ferritin <100 ng/ml.

Other Conditions

Serum ferritin has been shown to predict the risk of cirrhosis, in patients with hemochromatosis. The risk is extremely low for patients with serum ferritin levels less than 1000 micrograms/litre.

Elevated serum ferritin also predicts end-organ involvement in iron overload conditions, such as transfusion-associated iron overload in myelodysplastic syndromes, thalassemia and hemoglobinopathies. Levels less than 1500 ng/ml indicated mostly acceptable iron overload; levels greater than or equal to 3000 ng/ml were specific for significant iron-overload and were associated with liver injury. (Accurate assessment of iron levels is required in those with levels between 1500 and 3000 ng/ml.).

Serum ferritin levels may also be raised in many malignancies like neuroblastoma and breast cancer. Exact reason is however unknown but studies suggest that ferritin is merely being a serum maker and does not contribute to cancer etiology.

Book your test with us, know the ferritin test cost and access results from the ease of your home.

Always get your results interpreted through a medical professional. Test results may need to be evaluated alongside the clinical symptoms and can require other lab tests as well. 

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