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Ferritin: Understanding Low and High Levels

Ferritin is a crucial blood protein responsible for storing and releasing iron as needed by the body. It plays a key role in iron metabolism, ensuring that iron is properly utilized while also protecting vital cellular components like lipids, DNA, and proteins from iron’s potential toxic effects.

To determine how much iron the body has stored, a ferritin blood test is conducted. This test measures ferritin levels in nanograms per milliliter (ng/mL) of blood. A deficiency in ferritin suggests that the body lacks sufficient iron, leading to iron deficiency anemia. On the other hand, excessive ferritin—typically above 500 ng/mL—can indicate conditions like infections, liver disease, rheumatoid arthritis, hyperthyroidism, or type 2 diabetes.

What is Ferritin?

Ferritin serves as the body’s iron reservoir, a soluble protein that dissolves, stores, and regulates iron release when needed. This iron is vital for red blood cell production and oxygen distribution throughout the body. The ferritin test is the primary method used to assess blood iron levels.

A low ferritin test result indicates depleted iron stores, leading to iron deficiency, also known as iron deficiency anemia. Iron is essential for producing healthy red blood cells, which transport oxygen from the lungs to all body tissues. In children, it also supports muscle, brain, and bone marrow development.

Ferritin is primarily found within cells, particularly in hepatocytes (which make up approximately 75% of liver cells), bone marrow, and immune system cells. A single ferritin protein can store about 4,500 iron molecules.

What are Normal Ferritin Levels?

Ferritin levels vary based on age and gender. Normal ranges include:

  • Men: 20-500 ng/mL
  • Women: 20-200 ng/mL
  • Newborns: 25-200 ng/mL
  • Infants (1 month old): 200-600 ng/mL
  • Infants (2-5 months old): 50-200 ng/mL
  • Infants (6 months old and older): 7-142 ng/mL

A ferritin test can help diagnose conditions such as iron deficiency anemia, restless leg syndrome, hemochromatosis (excess iron absorption from food), liver disease, and systemic autoinflammatory diseases.

Results below the lower limit suggest low iron storage, while values exceeding the upper limit indicate high ferritin levels.

What is Low Ferritin?

A ferritin level below 20 ng/mL is considered low, indicating depleted iron stores and potential iron deficiency anemia. This condition results in insufficient red blood cells to carry oxygen efficiently throughout the body.

Causes of Low Ferritin

Low ferritin can stem from various factors, including:

  • Poor iron intake (diet lacking iron-rich foods)
  • Reduced gastrointestinal absorption (due to conditions like Crohn’s disease, celiac disease, ulcerative colitis)
  • Blood loss (from hemorrhoids, colon cancer, peptic ulcers, heavy menstrual cycles, pregnancy, miscarriage, frequent childbirth)
  • Frequent consumption of processed meats
  • Excessive tea and coffee intake
  • Vitamin C deficiency
  • Chronic illnesses
  • Post-surgical or injury-related blood loss
  • Gastrointestinal issues (such as stomach ulcers, colon polyps, or diverticulitis)

Symptoms of Low Ferritin

Common symptoms of low ferritin include:

  • Fatigue and weakness
  • Pale complexion
  • Shortness of breath and chest pain
  • Irregular or rapid heartbeat
  • Dizziness and headaches
  • Brittle nails
  • Hair loss
  • Ringing in the ears (tinnitus)
  • Cold intolerance
  • Forgetfulness and difficulty concentrating
  • Muscle and joint pain
  • Unusual cravings (eating soil or chalk)

Diseases Linked to Low Ferritin

Low ferritin levels can negatively impact red blood cell production, metabolism, and hormone synthesis, potentially leading to:

  • Iron deficiency anemia
  • Weakened immune function
  • Cardiovascular disease
  • Neurological disorders
  • Restless legs syndrome
  • Digestive issues
  • Pregnancy complications (such as preterm birth and low birth weight)
  • Chronic fatigue syndrome
  • Hair loss (telogen effluvium)

How to Increase Ferritin Levels

To boost ferritin levels, it is crucial to identify and address the root cause. If no underlying medical condition is responsible, dietary changes can help:

  • Consume iron-rich foods such as lean red meat, lentils, beans, raisins, eggs, spinach, broccoli, kale, and iron-fortified cereals.
  • Increase vitamin C intake to enhance iron absorption.
  • Reduce tea, coffee, alcohol, and smoking, as they can inhibit iron absorption.

What is High Ferritin?

High ferritin levels indicate an excess of stored iron in the body. Elevated levels often correlate with inflammatory conditions, liver disease, type 2 diabetes, rheumatoid arthritis, malignancies, or hyperthyroidism.

Symptoms of High Ferritin

Symptoms vary but often include:

  • Fatigue and weakness
  • Heart complications
  • Abdominal pain
  • Joint discomfort
  • Unexplained weight loss
  • Stomach pain
  • Hair loss
  • Decreased libido
  • Low energy levels

If left untreated, high ferritin levels can have toxic effects on the body, leading to serious health complications.

Treating Ferritin Deficiency

Treatment depends on the individual’s condition. Doctors may prescribe:

  • Iron supplements (tablets, syrups, or intravenous iron therapy)
  • Vitamin B12 supplements for B12 deficiency
  • Folic acid supplements for folic acid deficiency
  • Erythropoietin therapy in chronic kidney disease
  • Blood transfusions in severe anemia cases
  • Immune-suppressing medications if the immune system is attacking red blood cells
  • Bone marrow transplants for bone marrow-related anemia

Treatment usually lasts 3-6 months, and adherence is crucial to prevent recurring iron deficiency.

Is High Ferritin Dangerous?

Yes. Elevated ferritin levels require investigation to determine underlying causes. If no illness is found, ferritin levels can be lowered with dietary adjustments under medical supervision, including:

  • Increasing coffee and green tea consumption (to inhibit iron absorption)
  • Taking calcium, zinc, and magnesium supplements
  • Engaging in long-duration physical activity

Ferritin Deficiency in Children

Children with low ferritin levels require immediate medical attention. Blood tests are conducted to confirm iron deficiency. Treatment typically involves:

  • Daily iron supplementation (3-5 mg per kg of body weight)
  • Iron-rich diet recommendations for parents
  • Monitoring ferritin levels regularly to track improvement

Ignoring iron deficiency in children can lead to weakened immunity and developmental issues.

Frequently Asked Questions About Ferritin

What does ferritin indicate in blood tests?

Ferritin is a protein that stores iron in cells. It regulates iron levels, ensuring enough iron is available while protecting cells from iron toxicity.

How do you know if ferritin is low?

Symptoms such as fatigue, weakness, pale skin, breathlessness, dizziness, and hair loss may indicate low ferritin.

What ferritin level is dangerous?

A ferritin level above 1000 ng/mL is concerning, as it may signal serious conditions such as liver cirrhosis, cancer, or infections.

Is ferritin the same as iron?

No. Iron is a mineral used by red blood cells to transport oxygen, while ferritin is a protein that stores and releases iron when needed.

Which vitamins help increase ferritin?

Vitamin C enhances iron absorption, thereby improving ferritin levels.

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