Ferritin Test

Serum ferritin is a blood test commonly performed independently or as part of an iron profile test. Ferritin is a protein found in the blood. Its levels help to estimate the levels of iron in the body. It is also an acute-phase reactant produced during inflammation.

Ferritin is the Main form in which iron is stored in the body. Measuring its levels is important in cases of suspected iron overload or iron deficiency. Ferritin is not normally present in the blood in large quantities. It is mainly stored in the liver and spleen. These are the organs where iron is stored.

As the body continues to produce new blood cells, a small amount of ferritin is released into the blood. Its main purpose is to act as a reserve for when enough iron is not available.

High ferritin levels usually cause stomach aches, joint pain, weakness or fatigue and chest pain. It may also damage the liver. This condition requires early intervention and treatment.

Low ferritin levels are usually accompanied by tiredness, headaches, shortness of breath and tachycardia (increased heartbeat rate). A mild deficiency may go unnoticed and symptoms are usually seen with severe deficiency.

Ferritin levels reflect the amount of iron in the body. The good news is that with correct lifestyle changes and diet modifications, many of these conditions that cause iron deficiency can be managed with medicines. There are several foods that are rich sources of iron. This includes green, leafy vegetables, dried fruits, red meat and seafood. One can incorporate them into their diet.

Iron deficiency is the most common cause of anaemia in India. Low levels of ferritin are seen in iron deficiency. This has largely been attributed to nutritional causes.

Other Names of Serum Ferritin Test

Ferritin tests may be represented as blood ferritin, serum ferritin and sometimes as a part of the iron profile.

What does the test measure and who needs this test?

The serum ferritin test measures the level of ferritin protein. In very simple terms, ferritin is the form in which iron is stored in the body. Ferritin is carried by the red blood cells (RBC). RBCs play the vital function of carrying oxygen from your lungs with the help of iron. Iron deficiency anaemia is very common and usually results from a deficiency of iron in the diet. In this condition, ferritin levels are very low. It indicates inadequate iron stores in the body.

It is also needed in case of genetic disorders such as hemochromatosis and porphyrias. These result in elevated levels of ferritin. Serum ferritin levels are also high in cases of organ dysfunction and are a marker of inflammation in the body. It means that in case of any infection or acute disease, the levels may rise.

The symptoms of low ferritin levels include:

• Pale skin
• Unexplained fatigue
• Weakness/exhaustion
• Longstanding headaches
• Dizziness
• Difficulty in breathing
• Higher pulse rate
• Irritability
• Leg ache

The symptoms of high ferritin levels include:

• Stomach ache
• Chest pain and irregular pulse or palpitations
• Weakness that remains persistent
• Pain in the large joints such as knees and elbows

These are some of the symptoms for which a doctor may prescribe a ferritin test.

A simple venous blood sample is sufficient to test blood levels of ferritin. The levels are detected in the serum, which is a component of the blood. This sample may be drawn from any of your prominent veins, the most common being the vein in your arm. It does not require any prior preparation.

Test Preparation

There is no preparation required for the test. However, the test is sometimes advised to be performed on an empty stomach in the morning for increased accuracy. It is not a rule and the test can be performed without fasting as well.

Test Inclusions

Serum ferritin is an individual test. It only measures the levels of a single protein, that is, ferritin. It may be included as a component of a test known as an iron profile.

In case of low haemoglobin levels, the iron profile test may be advised. This also measures serum iron levels and total iron-binding capacity (TIBC).

Serum ferritin levels give an estimate of iron stores in the body. Serum ferritin test as a standalone test may be advised if you are prone to high iron levels due to iron storage disorders such as hemochromatosis. This results in high levels of iron and consequently, high ferritin levels.

Liver damage, Ulcers, Hemochromatosis, Anaemia

The standard levels of serum ferritin for adults lie between 13 - 322 ng/mL. You may also get the following values in some labs:

• Normal serum ferritin level for men: 24 to 336 micrograms per litre
• Normal serum ferritin level for women: 11 to 307 micrograms per litre

These levels may vary from lab to lab. It is always advisable to check the normal range in your laboratory before interpreting the results.

The results of the serum ferritin levels above or below the normal range require additional tests and investigations. Certain medications may also interfere with serum ferritin levels. In case of any derangement in levels, your doctor may review all the components of the iron profile to pinpoint a specific cause.

The causes of high ferritin levels include:

• COVID-19 (during cytokine storm)
• Hemochromatosis (a genetic disorder causing the body to store large amounts of iron)
• Chronic inflammation, for example, rheumatoid arthritis
• Liver failure (it might indicate a worse outcome in such cases)
• Hyperthyroidism (an overactive thyroid gland)
• Blood cancers, including leukaemia and Hodgkin's lymphoma
• Repeated blood transfusions
• Alcohol abuse

One of the main causes of low serum ferritin levels is iron deficiency. Iron deficiency anaemia manifests in various ways. It mainly indicates that the ability of your body to carry vital oxygen is reduced. The main causes for low ferritin include:

• Iron deficiency anaemia (likely due to nutritional deficiency of iron)
• Chronic heavy periods and excess blood loss during menstruation
• Stomach ulcers (peptic ulcers) - these also cause chronic blood loss
• Internal bleeding
• Loss of blood in stools due to infections or tumours
• Malabsorption or the inability to correctly absorb nutrients from food