Ferritin Test

A Ferritin test measures the level of ferritin protein present in the blood. It is also called the serum ferritin test, serum ferritin level, or ferritin blood test.Ferritin is the main protein that stores iron in your body. Around 70% of iron in men and 80% in women is stored in ferritin, while a smaller amount is stored in another protein called haemosiderin. Ferritin is mainly found in the liver, bone marrow, spleen, and muscles, but a small amount is released into the blood when iron is needed. Iron is essential for producing haemoglobin in red blood cells, which carries oxygen in the blood. Without enough iron, haemoglobin levels drop, leading to anaemia.

The level of ferritin in the blood directly shows how much iron is stored in the body. Doctors use the Ferritin test to check whether iron stores are low, normal, or high. Low ferritin levels indicate less iron in the body that can be due to a poor diet, long-term blood loss (like heavy periods, stomach ulcers or haemorrhoids), or increased needs such as in pregnancy. High ferritin levels can occur due to excess iron in the body, acute inflammation, or autoimmune or liver disease.

Thus, this test specifically focuses on iron storage, haemoglobin production, red blood cells, and organs like the liver and bone marrow that manage and store iron.

The Ferritin test is done when signs of very low or very high iron levels in the body are observed. Signs of low iron levels include:

• Feeling tired or weak
• Trouble breathing (shortness of breath)
• Feeling dizzy
• Pale-looking skin
• Irregular heartbeat (heartbeat not normal)
• Restless legs (need to move legs often)

Signs of high iron levels include:

• Feeling weak or tired
• Pain in joints like knees or hands
• Pain in the belly area
• Loss of interest in sex
• Skin turning grey, metallic, or bronze colour

Doctors also suggest this test for people who may not have symptoms but are at a higher risk of iron deficiency. These include:

• Those who do not get enough iron from food
• Pregnant women
• People with long-term blood loss, such as heavy periods or haemorrhoids
• People who cannot absorb food properly
• Underweight individuals

This test is also used by the doctors in the following cases:

• Suspicion or family history of Haemochromatosis (an inherited condition where the body absorbs and stores excess iron)
• Suspected liver disease
• Long-term illnesses like cancer or chronic kidney disease (CKD)

The Ferritin test is not done routinely. It is repeated based on your health condition and treatment needs.

The Ferritin test can support the diagnosis of iron-related and other health conditions, such as:

• Iron deficiency anaemia - A condition where the body does not have enough iron to produce healthy red blood cells. Ferritin is low because iron stores are depleted, leading to reduced haemoglobin production.
• Haemochromatosis (iron overload) - A genetic condition where the body absorbs and stores too much iron. Ferritin is high due to excess iron accumulation in organs like the liver, heart, and pancreas.
• Blood loss (acute or chronic) – Long-term blood loss, such as heavy menstrual bleeding or haemorrhoids, can gradually reduce iron levels in the body. Over time, this reduces ferritin levels (iron stores), and if it continues, it can lead to iron deficiency anaemia.
• Malabsorption: This reduces absorption of iron and vitamin B12, leading to low ferritin levels. This results in iron deficiency anaemia, commonly seen in conditions like celiac disease, gastrectomy, and H. pylori infection.
• Liver disease - Ferritin is mainly stored in the liver, so liver cell damage can increase ferritin levels in the blood.
• Chronic diseases – Conditions such as cancer, kidney disease, and autoimmune conditions can cause long-term inflammation. Ferritin may increase as it also acts as an inflammation marker.
• Restless legs syndrome - A neurological condition causing an urge to move the legs, often linked to low iron availability in the nervous system. Low ferritin levels are commonly seen in some cases.
• Adult Still disease - A rare inflammatory condition characterised by high fever, joint pain, and rash. Ferritin levels are often extremely high during active disease.

What to Expect Before the Ferritin Test

No fasting is required for a standalone Ferritin test. You can eat and drink normally. However, if it is part of a broader package that includes fasting tests, your doctor may advise fasting for 8-12 hours. Avoid strenuous exercise for 24 hours before the test, as intense physical activity can temporarily raise Ferritin levels and affect interpretation. Always inform your doctor about any ongoing medications.

What to Expect During the Blood Collection

A phlebotomist cleans the skin with an antiseptic, then places an elastic band around your upper arm to make the veins easier to access. A small needle is inserted into the vein; you may feel a brief pinch. Blood is collected into a labelled tube in under a minute.

What to Expect After the Ferritin Test

A small cotton swab and bandage are placed over the site to stop any minor bleeding. You can return to normal activities immediately. Minor bruising is normal and disappears quickly. If dizzy, sit and rest for a few minutes.

This test measures a single key parameter:

• Ferritin levels in blood - This gives an estimate of iron reserve in the body.

A Ferritin test may be done separately, but it is usually ordered as part of a group of tests known as iron studies, which includes other parameters like iron levels, transferrin, and total iron binding capacity.

The table below presents ferritin normal values based on gender:

The table below shows what different Ferritin test results may mean:

Note:
Ferritin results should always be understood with symptoms and doctor advice, as this test alone cannot confirm a condition. It is usually a simple blood test included in iron studies panels.

Possible risks

The ferritin blood test is generally safe, with only some minor risks, such as:

• Mild pain when the needle is inserted
• Slight bruising at the needle site

These effects are usually short-lived and go away quickly on their own.

Limitations

Limitations of the ferritin test include:

• High ferritin may not always mean excess iron; it can also be seen in liver disease, cancer, obesity, or autoimmune disorders. 
• Results can be difficult to interpret in chronic illnesses such as kidney disease or inflammatory bowel disease.
• Damage to organs that store ferritin can raise blood levels without true iron overload.
• Some medicines may increase or decrease ferritin levels, affecting accuracy. 

Because of these limitations, doctors do not rely only on this test. It is usually combined with other iron tests, like iron levels or total iron binding capacity, to get a clear picture of iron status.

Related tests include:

• Full blood count (checks blood cells)
• Iron test (measures iron in blood)
• Iron studies (a group of tests for iron balance)
• Transferrin (protein that carries iron)
• Total iron binding capacity - TIBC (shows iron-carrying capacity)
• Unbound iron binding capacity - UIBC (measures unused iron-binding space)
• Transferrin saturation (shows how much transferrin is filled with iron)

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