Ferritin Facts, Low Ferritin Symptoms, Ferritin Levels, Serum, Tests, Causes

What Is Ferritin?

Ferritin is a protein that binds with iron. Its function is to store iron and release it in a controlled fashion. In the human body, ferritin acts as a buffer against iron deficiency and iron surplus. Ferritin is present in blood serum and under normal conditions, it correlates with the total iron deposits in the body. Ferritin is also found in the mitochondria of body cells. Mitochondria is one of the cellular organelles. Here, it plays the role pertaining to molecular function. It takes part in ferroxidase activity, oxidoreductase activity, iron ion binding, ferric iron binding, transition as well as metal ion binding activity, etc. Since, ferritin participates in a number of biological processes that are vital to life, it is very important that it is present in an optimum concentration in your body. Any rise or fall in its level may result in numerous health issues. The optimum ferritin count is 30-300 ng/mL for men while 15-200 ng/mL for women.

Without adequate iron, the red blood cells do not carry enough oxygen because they lack hemoglobin. Hemoglobin requires iron to transport oxygen from the lungs to the rest of the body. A lack of red blood cells or a deficiency in hemoglobin is known as anemia. Having iron unbound is toxic, so the rest of it is bound to ferritin and found within the bone marrow, liver, skeletal muscles, and spleen. Some is carried in the blood, and this ferritin serum level correlates with the body's total iron stores.

What Is Serum Ferritin?

The ferritin that is found in bloodstream is referred to as serum ferritin. The storage and usage of proteins is the function carried out by this ferritin. Health of a person is largely dependent on the level of this substance. It is not only present in the human body, but also produced in systems of algae, bacteria, animals and higher plants. Serum ferritin plays an important role in the regulation of iron levels in blood.

What Are Normal Ferritin Levels?

Usually ferritin levels, also known as serum ferritin levels, are checked by means of a ferritin blood test, that indirectly determine the iron levels in the body. Depending on the results, you may determine whether or not you have low iron levels, or high iron levels in blood which may cause toxicity in the body, or any other associated conditions. The results of such a test are presented in terms of:

  • ng/mL or Nanograms per Milliliter

  • mcg/mL or Micrograms per Milliliter

The values will not be affected by the units used to represent them. Ferritin levels may fluctuate even in newborns, and the normal ferritin levels for each age/gender group have been mentioned here.

  • Newborns: 25-200 ng/mL

  • 1 month old Babies: 200-600 ng/mL

  • 2-5 month old Babies: 50-200 ng/mL

  • 6 month - 15 yr old Children: 7-142 ng/mL

  • Women: 18-160 ng/mL

  • Men: 18-270 ng/mL

Low Ferritin Levels

Ferritin is a small protein that is present in blood. This protein is a very important molecule as it is responsible for storing iron that is ingested in the diet. Ferritin stores iron in a non-toxic form, as free iron is toxic to the body. Hence, when a person shows symptoms of low ferritin levels, then tests are done to check for the same. The ideal range of serum ferritin levels for males is 30-400 ng/ml and for females it is 13-150 ng/ml. Thus, when there are low ferritin levels, symptoms exhibited include those seen in diseases like anemia and restless leg syndrome. Before we go onto the low ferritin level symptoms, let us first see what leads to decreased levels of ferritin in the blood.

Causes of Low Ferritin

There can be many different conditions that can lead to low ferritin levels. It is said that hypothyroidism is often implicated as a possible cause of low ferritin levels. This is because when there are low levels of thyroid hormone, then the amount of hydrochloric acid secreted in the stomach is quite less. Thus, there are low levels of ferritin, which leads to decreased absorption of iron. This is also seen in other diseases of the digestive tract where there is malabsorption in the gut.

Low ferritin levels may be caused in women if they suffer from heavy menstrual bleeding, or due to a lack of iron in their diet. Moreover, conditions such as ulcers and colon cancer may cause severe internal bleeding, causing ferritin levels to plummet. A ferritin deficiency may be indicated by symptoms such as fatigue, irritability, and overall weakness. You may be prescribed an iron supplement and be advised to eat iron enriched foods.

Symptoms of Low Ferritin

When there are low ferritin levels, symptoms will depend on the underlying cause that is responsible for the decreased amount of ferritin in the blood. However, the most common symptom that is seen are symptoms of iron deficiency anemia. In this condition, the low iron symptoms include severe weakness, fatigue, low energy levels, easy mental and physical exhaustion, pale skin, headaches, etc. Basically, all these symptoms are seen because as there is a deficiency of iron in the blood, there will be low hemoglobin and hematocrit, which will lead to decreased amount of oxygen reaching the cells. Thus, fatigue and overall weakness is seen. Other symptoms of anemia include brittle skin, hair loss, chronic irritability, breathless on doing any kind of strenuous physical activity. If there are very low ferritin levels, symptoms will be quite severe, like dizziness, depression, difficulty swallowing, poor memory, etc.

Leg cramps is also a common symptom seen. In fact, low levels of ferritin have been associated with restless leg syndrome, wherein there is an irresistible urge to constantly move one's legs due to constant discomfort, that may be mild or severe in nature. Every one in five cases of people that complain of restless leg syndrome are diagnosed with iron deficiency anemia and low ferritin symptoms. If a person has hypothyroidism, then besides the symptoms of low iron and oxygen levels in the body, he will also show symptoms of hypothyroidism, like lethargy, drowsiness, decreased metabolic rate, weight gain, intolerance towards cold, etc. If the person has malabsorption syndrome, then there will mostly be other symptoms like deficiency of other minerals, vitamins and food groups seen. Hence, the types and severity of ferritin deficiency symptoms is largely dependent on the underlying cause, though, symptoms of iron deficiency anemia are almost always present.

Low Ferritin Test

Serum iron test, ferritin test, TIBC (total iron binding capacity) and UIBC (unsaturated iron binding capacity) are some of the diagnostic tests that are usually conducted in order to ascertain the levels of iron in the body. Out of these, the ferritin test helps in ascertaining the total iron storage capacity of the body. Under normal circumstances, ferritin levels in men must be within the range of 12 to 300 nanograms per milliliter, whereas for females, the normal ferritin levels must lie within 12 to 150 nanograms per milliliter. If the test results reveal low ferritin levels, then doctors would need to investigate further so as to identify the reasons for low ferritin levels.

One should not take any iron supplements for 12 hours or Vitamin B12 supplements for 48 hours before having blood drawn for a ferritin blood test. Also, it is best to have the blood drawn in the morning, since iron levels change throughout the day. They are highest soon after waking.

Treatment of Low Ferritin

Increase Dietary Intake of Iron: As low ferritin indicates an iron deficiency, consumption of iron-rich foods is the best way to restore the ferritin levels back to normal. Consumption of iron-enriched foods such as clams, chicken, lean red meat, oysters, liver, turkey, molasses, tofu, figs, raisins and iron fortified cereals would surely prove beneficial. Though sources of heme iron (animal sources of iron) are more readily absorbed than the non-heme sources (plant sources of iron), if you are a vegetarian you should include iron-rich foods such as pumpkin seeds, beans, leafy green vegetables, soybeans, cooked spinach, chickpeas, oatmeal, sweet potatoes and broccoli to your diet. Since excessive intake of caffeinated drinks can have an adverse effect on the absorption of iron, one must cut down on the intake of such drinks. Since vitamin C aids in the absorption of iron, consumption of iron-enriched foods along with foods that contain vitamin C will greatly assist in elevating the ferritin levels.

Iron Supplementation: If making these dietary modifications is not giving the desired result, you could also take iron supplements. If low ferritin is detected soon, supplementation can prevent one from developing a severe iron deficiency anemia. It would, however, be best to consult a doctor to find out the appropriate dosage required to correct the imbalance. It would be best to take ferrous iron salts as they have high elemental iron content. Elemental iron basically means the amount of iron in the pill that is absorbed by the body. Ferrous sulfate, ferrous gluconate and ferrous fumarate figure in the list of iron salts that contain the highest amount of elemental iron. The dosage, however, will depend on the condition of the patient. One must always adhere to the prescribed dosage. Under no circumstances, should one change the dosage.

Poor dietary habits emerge as one of the most common causes of low ferritin levels, however, severe blood loss or an underlying medical condition could also be responsible for lowering the levels of ferritin. If ferritin test and other blood tests reveal abnormal ferritin levels, one must get a thorough medical checkup done. While dietary modification and iron supplementation may surely help to a great extent, in some cases the treatment of an underlying medical condition may be required to elevate the levels of ferritin in blood.

High Ferritin Levels

High ferritin levels are unusually high levels of ferritin, a compound the body uses to store iron in its tissues so it will be available when it is necessary. A doctor can order a blood test to check on levels of this compound if she suspects a patient may have a disorder related to abnormal ferritin levels. The test can include evaluation for other compounds to provide a complete picture of the patient's health, along with references the doctor can use to rule out some possible causes if the patient's ferritin levels are higher than they should be.

Causes of High Ferritin

Genetic predisposition is the basic reason behind the condition of high ferritin levels in the body. However, it can occur due to many non-genetic factors as well. The non-genetic causes of high ferritin levels include blood disorders, chronic hepatitis, excessive iron intake and chronic transfusion therapy. High levels of ferritin can be one of the symptoms of several diseases. These are alcoholic liver disease, megaloblastic anemia, Hodgkin's lymphoma, hemolytic anemia, hemochromatosis, etc.

Hemochromatosis is a disease that causes drastic elevations in ferritin. Patients with this genetic disease are not able to remove iron from their bodies, and throughout their lifetime build up more and more iron. When they reach middle age, this iron excess can cause diabetes, problems with liver function, and a brown discoloration of the skin. Patients who receive many blood transfusions over the courses of their lives, for example those with a condition called thalassemia, can also have excess iron stores.

Sometimes patients with certain cancers will have high levels on a ferritin test. Malignancies such as leukemia and lymphoma can be associated with high levels of this carrier protein. In this case, levels of ferritin are high because the abnormal cancer cells can produce this protein.

Many times elevated levels in the ferritin test can signal the presence of inflammation in the body. The protein is considered an acute phase reactant, which means that its levels rise when the body is fighting off a stressor. Some researchers suggest that ferritin levels rise when patients are trying to fight off bacteria to keep them from using the body's iron for their own use. Chronic inflammatory conditions, such as rheumatoid arthritis, are also associated with elevations in ferritin levels.

Symptoms of High Ferritin

In the initial stage, the high ferritin level symptoms usually go unnoticed. It is mostly determined when blood work is conducted to find the levels of ferritin in the body. There are some symptoms that are identifiable with the passage of time. High levels of ferritin gives rise to numerous uncomfortable symptoms. It leads to deposition of iron in the body, especially in the joints. As a result, you have to suffer from pain throughout the body, particularly in the joints. The elevated ferritin blood levels cause darkening of the skin. Other signs and symptoms of high ferritin levels include lethargy, fatigue, pain in the abdomen, and various cardiac problems. Iron deposition can lead to organ damage. Women lose iron or ferritin through blood loss during menstruation. This saves them from the danger of organ damage to some extent.

High Ferritin Test

High ferritin level in the body is diagnosed by two simple and inexpensive blood tests. These are transferrin saturation and serum ferritin. You need to fast for both these blood tests. These tests are generally ordered because serum ferritin level is directly related to the amount of iron present in the blood. If these tests show high levels of iron then other serum tests like total iron binding capacity (TIBC) and unsaturated iron binding capacity (UIBC) may also be conducted.

One should not take any iron supplements for 12 hours or Vitamin B12 supplements for 48 hours before having blood drawn for a ferritin blood test. Also, it is best to have the blood drawn in the morning, since iron levels change throughout the day. They are highest soon after waking.

Treatment for High Ferritin

The treatment for high ferritin levels aims at reducing its levels and bringing it to normal. A preferred way of doing this is therapeutic phlebotomy. It is the procedure that involves removal of blood from the body. Usually, one unit of blood is removed once or twice a week. You need to undergo therapeutic phlebotomy on a weekly basis till excess ferritin or iron has been removed from your body. The level of ferritin in the blood is monitored continuously throughout the treatment. The length and frequency of treatment depends upon the gender, age, reason for diagnosis and seriousness of symptoms. Once the optimum levels of ferritin have been reached, the sessions of phlebotomy are reduced to 2-3 times a year. The frequency is determined according to the patient's symptoms and levels of serum ferritin and hemoglobin.

Intake of chelates may also help. Chelation is the process of removing a heavy metal from the bloodstream. Chelates bind to excess metal in the blood and help in its removal. Phytic acid (present in the hull of nuts and seeds), natural amino acids and ethylenediaminetetraacetic acid (EDTA) are good chelates. However, the intake of chelates should be done after consulting a doctor only and the process should be carefully monitored. The reason is that these chelates also bind with other metals like zinc and minerals like calcium, and excessive intake may result in their deficiency.

The next step, of course, is to reduce the intake of iron rich foods such as spinach, beans, red meat, raisin, dried apricot and dried peaches, etc. Also, stop taking any supplements that contain iron.

If you have not developed any organ damage due to high ferritin levels, you can lead a healthy life after undergoing a successful therapeutic phlebotomy. In case you have got any of your organs damaged, you can restrict the progression of high ferritin levels. This will save you from further organ damage. You will also notice reduction in the symptoms and discomfort. Do not self-medicate in case of high ferritin levels. Always consult a doctor and strictly follow all the instructions and recommendations given by him. This will surely improve your life expectancy.

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